Antonia Forsyth Diller, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34926 Issued in CA

Practice address

1775 Harrison Ave
Eureka, CA 95501-1338

Phone

(707) 616-6156

NPI assigned

Oct 1, 2020

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

Other names 1

• Dr. Antonia Juliette Forsyth Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Care Chiropractic Fogg Professional CorporationGroup PAC ID 9133427792, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Active Care Chiropractic, Fogg Professional Corporation

  dba Active Care Chiropractic

  • Chiropractor
  • Eureka, CA
  • NPI 1356707772
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1790382828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011338",
            "telephone_number": "707-616-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011338",
            "telephone_number": "707-616-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLER",
        "first_name": "ANTONIA",
        "middle_name": "FORSYTH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIA",
            "last_name": "FORSYTH",
            "middle_name": "JULIETTE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laetitia Dickinson
• Gabriela Diego
• Stephen R Dieker Jr., MD
• Justin Diesslin
• Suzanne Dietz, PNP
• Jennifer Diane Diller
• Tara Dillon
• Ijeoma Dinneya-George, BSN, PHN, RN-BC
• Dinsmores Inpatient Services a Medical Corporation
• John Eldred Disiere, M.D.

• Chiropractor in Eureka, CA
• Providers in Eureka, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.