John R. Destito, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

052346 Issued in GA

Practice address

1800 Howell Mill Rd NW
Suite 130
Atlanta, GA 30318-2538

Phone

(404) 355-8775

Fax

(404) 355-8772

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Afc Physicians of Georgia Primary Care, PC

  • Primary Care Clinic/Center
  • Ft. Oglethorpe, GA
  • NPI 1780062380

  GA

  Medicare reassignment NPD
• Afc Physicians of Georgia Urgent Care, PC

  • Urgent Care Clinic/Center
  • Marietta, GA
  • NPI 1225617525

  GA

  Medicare reassignment NPD
• Afc Physicians of Georgia, PC

  • Urgent Care Clinic/Center
  • Chamblee, GA
  • NPI 1982950671

  GA

  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156

  GA

  Medicare reassignment NPD
• Afc Physicians of Georgia Primary Care, PC

  • Primary Care Clinic/Center
  • Ft Oglethorpe, GA
  • NPI 1083005565
  NPD
• Afc Physicians of Georgia, PC

  • General Practice Physician
  • Woodstock, GA
  • NPI 1518388941
  NPD
• Afc Physicians of Georgia, PC

  • General Practice Physician
  • Columbus, GA
  • NPI 1982025318
  NPD
• Acworth Immediate Care LLC

  • Emergency Medicine Physician
  • Acworth, GA
  • NPI 1326218942

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1770540841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "address_2": "SUITE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "404-355-8775",
            "fax_number": "404-355-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "address_2": "SUITE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "404-355-8775",
            "fax_number": "404-355-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTITO",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "052346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA",
            "identifier": "52230468001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100069810A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "976398941A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destination Greatness-Georgia, LLC
• Destination Unlimited Clinical Services, LLC
• Destiny Family Medical Center, LLC
• Destiny'S Child Inc
• Destinys Doors LLC
• Kim Desue
• Richard L Detlefs, M.D.
• Mara Detrani, PA
• Matthew Robert Detter, MD, PHD
• Jessica Detwiler

• All providers in Atlanta, GA
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.