Active NPI
Larissa Ann Dibella, D.C.
- Chiropractor
- Gastonia, NC
National Provider Identifier
1841258779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2255
- Practice address
- 528 Union Rd
Gastonia, NC 28054-4450 - Phone
- (704) 867-1010
- Fax
- (704) 868-2602
- NPI assigned
- May 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2255 | NC | Primary |
Addresses
Primary practice location
528 Union Rd
Gastonia, NC 28054-4450
Mailing address
528 Union Rd
Gastonia, NC 28054-4450
Phone (704) 867-1010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890282P | Medicaid | NC |
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 |
|---|---|---|---|
| 2255 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195430400000",
"number": "1841258779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 UNION RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544450",
"telephone_number": "704-867-1010",
"fax_number": "704-868-2602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 UNION RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544450",
"telephone_number": "704-867-1010",
"fax_number": "704-868-2602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBELLA",
"first_name": "LARISSA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2007-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890282P",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.