Individual provider Active NPI

Jane Ellen Dinerman, D.C.

  • Chiropractor
  • Decatur, GA
National Provider Identifier
1770611451
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002592 Issued in GA
Practice address
2545 Lawrenceville Hwy
100
Decatur, GA 30033-3239
Phone
(404) 378-6300
Fax
(770) 939-9353
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 002592 GA Primary

Addresses

Primary practice location

2545 Lawrenceville Hwy
100
Decatur, GA 30033-3239

Mailing address

917 Scott Blvd
Decatur, GA 30030-1303
Phone (404) 378-8978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081008000051 GA Practitioner - Chiropractic 8921176694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 Montreal Rd
Suite 100
Tucker, GA 30084-6919
Phone (404) 377-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tao Chiro LLC CurrentSince Oct 8, 2008 Accepting new patients

Locations

2545 Lawrenceville Hwy
Ste 100
Decatur, GA 30033
Phone (404) 377-0011

1400 Montreal Rd
Ste 100
Tucker, GA 30084
Phone (404) 377-0011

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1770611451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 SCOTT BLVD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301303",
            "telephone_number": "404-378-8978",
            "fax_number": "404-378-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 LAWRENCEVILLE HWY",
            "address_2": "100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333239",
            "telephone_number": "404-378-6300",
            "fax_number": "770-939-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINERMAN",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "002592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.

Verify at the official NPI Registry.