P Praxis·MD
● Active Type 1 · Individual

John Carmen Dercola, PA

Physician Assistant·Marietta, GA· NPI 1417952433 · Enumerated 2005 · 20 years on NPI
Dercola is 1 of 73 physician assistant providers in Marietta and 1 of 1333 in Georgia.
NPI age
20 years
Enumerated 2005-06-16
Primary specialty
Physician Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2013-01-02
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 1333 active physician assistant providers in Georgia.

NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
21% of peers hold subspecialties

NPI lifetime · 2005 → 2026

2005-06Enumerated in NPPES
2005 2026

Where they practice

Practice location
55 Whitcher St Ne, Suite 350
Marietta, GA 300601155
📞 7704246893fax 7705289926
Mailing address
55 Whitcher St Ne, Suite 350
Marietta, GA 300601155
📞 7704246893fax 7705289926

Specialties

  • Physician Assistant Primary
    Definition to come...
    GA license #002707 taxonomy 363AM0700X

Identifiers

TypeValueNotes
05 (GA) 100001072G
05 (GA) 100001072F-
05 (GA) 100001073B
05 (GA) 100001073C
05 (GA) 100001072H

Practice context

Part of a multi-provider practice. 178 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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