Active NPI
Gabriel Justin Dimock, PT, DPT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1598379299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P19727
- Practice address
- 8300 Health Park Ste 127
Raleigh, NC 27615-4731 - Phone
- (919) 845-6160
- NPI assigned
- Sep 1, 2020
- Sex
- Male
- 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 | P19727 | NC | Primary |
Addresses
Primary practice location
8300 Health Park Ste 127
Raleigh, NC 27615-4731
Mailing address
16 Maybrook Rd Ste D
Campbell Hall, NY 10916-2741
Phone (845) 636-4344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P19727 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1598379299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MAYBROOK RD STE D",
"city": "CAMPBELL HALL",
"state": "NY",
"postal_code": "109162741",
"telephone_number": "845-636-4344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 HEALTH PARK STE 127",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276154731",
"telephone_number": "919-845-6160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMOCK",
"first_name": "GABRIEL",
"middle_name": "JUSTIN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P19727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.