Active NPI
Amanda Dizinno, LOTR
- Pediatric Occupational Therapist
- Lawrenceville, GA
National Provider Identifier
1851401731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Practice address
- 1509 Atkinson Rd
Suite 1100
Lawrenceville, GA 30043-7986 - Phone
- (770) 995-2379
- Fax
- (770) 995-2385
- NPI assigned
- Aug 30, 2006
- Last updated
- Oct 27, 2010
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | NU | Primary |
Addresses
Primary practice location
1509 Atkinson Rd
Suite 1100
Lawrenceville, GA 30043-7986
Mailing address
1509 Atkinson Rd
Suite 1100
Lawrenceville, GA 30043-7986
Phone (770) 995-2379
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10077024 | Other | AMERIGROUP | |
| 375135543A | Other | GA | PEACHSTATE |
| 371948 | Other | WELLCARE | |
| 375135543A | Medicaid | GA |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Works,P.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Lawrenceville, GA
- NPI 1801959838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1851401731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 ATKINSON RD",
"address_2": "SUITE 1100",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437986",
"telephone_number": "770-995-2379",
"fax_number": "770-995-2385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 ATKINSON RD",
"address_2": "SUITE 1100",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437986",
"telephone_number": "770-995-2379",
"fax_number": "770-995-2385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIZINNO",
"first_name": "AMANDA",
"credential": "LOTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10077024",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEACHSTATE",
"identifier": "375135543A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "371948",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "375135543A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.