Althea Charity Dimaculangan, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

178925 Issued in GA

Practice address

345 Huntington Place CT
McDonough, GA 30253-8651

Phone

(678) 272-7280

Fax

(678) 610-6025

NPI assigned

May 19, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Locust Grove Family MedicineGroup PAC ID 1052306008, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19518/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/GDIGDD

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.

• Locust Grove Family Medicine

  • Non-Pharmacy Dispensing Site
  • Locust Grove, GA
  • NPI 1629169164
  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment
• Reliance Family Care

  • Family Medicine Physician
  • McDonough, GA
  • NPI 1699912113
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1609255066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "678-272-7280",
            "fax_number": "678-610-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "678-272-7280",
            "fax_number": "678-610-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMACULANGAN",
        "first_name": "ALTHEA",
        "middle_name": "CHARITY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "178925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diagnostic Go Mobile
• Raymond Scott Dickerson, PA-C
• Shanice Nicole Dickerson
• Sarah Dickinson, DMD
• Kimberly Faith Dillard, N.P.
• Divine Harvest Home Care Services, LLC
• DNM Health Services
• Thu Anh Doan, DMD
• McKenzie Washington Dodson, M. ED., CCC-SLP
• Domi Healthcare Services, LLC

• Family Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.