Active NPI
Jami Nicole Difabio, DPT
- Physical Therapist
- Gainesville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT021335
- Practice address
- 2480 Limestone Pkwy Ste 107
Gainesville, GA 30501-2088 - Phone
- (770) 967-4377
- NPI assigned
- Sep 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT021335 | OH | Primary |
Addresses
Primary practice location
2480 Limestone Pkwy Ste 107
Gainesville, GA 30501-2088
Mailing address
6204 New Holland Way NE Unit 6204
Gainesville, GA 30501-0019
Other practice location 1
4754 Martin Rd # 200
Flowery Branch, GA 30542-3507
Phone (770) 967-4377
Other practice location 2
415 Horizon Dr Ste 250
Suwanee, GA 30024-4647
Phone (678) 505-1995
Other practice location 3
2300 Liam Ave
Dacula, GA 30019-2263
Phone (470) 294-0052
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241204004300 | GA | Practitioner - Physical Therapist in Private Practice | 9234665944 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Back in the Game Physical Therapy, Inc
Practice addresses (Care Compare)
4754 Martin Rd
Suite 200
Flowery Branch, GA 30542-3507
Phone (770) 967-4377
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT021335 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back in the Game Physical Therapy, Inc | Current | Accepting new patients | |
| Northeast Georgia Rehabilitation Center,Inc | Past | Accepting new patients |
Locations
2300 Liam Ave
Ste 104
Dacula, GA 30019
Phone (470) 294-0052
2300 Liam Ave
Dacula, GA 30019
Phone (470) 294-0052
4754 Martin Rd
#200
Flowery Branch, GA 30542
Phone (770) 967-4377
2480 Limestone Pkwy
Ste 107
Gainesville, GA 30501
Phone (770) 967-4377
2800 Horizon Ridge Ct
Ste 250
Suwanee, GA 30024
Phone (678) 505-1995
415 Horizon Dr
Ste 250
Suwanee, GA 30024
Phone (678) 505-1995
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Flowery Branch, GA
- NPI 1962669275
GA
-
- Physical Therapy Clinic/Center
- Royston, GA
- NPI 1821008087
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1548096647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6204 NEW HOLLAND WAY NE UNIT 6204",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305010019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LIMESTONE PKWY STE 107",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305012088",
"telephone_number": "770-967-4377"
}
],
"practiceLocations": [
{
"address_1": "4754 Martin Rd # 200",
"address_purpose": "LOCATION",
"city": "Flowery Branch",
"state": "GA",
"postal_code": "305423507",
"country_code": "US",
"telephone_number": "770-967-4377",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "415 Horizon Dr Ste 250",
"address_purpose": "LOCATION",
"city": "Suwanee",
"state": "GA",
"postal_code": "300244647",
"country_code": "US",
"telephone_number": "678-505-1995",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2300 Liam Ave",
"address_purpose": "LOCATION",
"city": "Dacula",
"state": "GA",
"postal_code": "300192263",
"country_code": "US",
"telephone_number": "470-294-0052",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIFABIO",
"first_name": "JAMI",
"middle_name": "NICOLE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-13",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT021335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.