DR. JEREMY LEE DICKERSON (NPI# 1043446206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043446206 |
| Entity Type | Individual |
| Full Name | DR. JEREMY LEE DICKERSON |
| Credential | MD |
| Practice Address |
1139 E Sonterra Blvd Ste 205 San Antonio TX 78258-4349 |
| Mailing Address |
Po Box 847824 Dallas TX 75284-7824 |
| Practice Telephone | 2108743359 |
| Mailing Telephone | 9038777777 |
| Mailing Fax Number | 9038775080 |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2019-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | BP10035367 | TX | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
P4860 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 414 Navarro St, Suite 1616, San Antonio, TX 782052516 | 2102242655 | 8666440889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114469202 | Jeremy Dickerson | Massage Therapist | 5995 Williamsville Rd, Milford, DE 19963-6314 | 2016-11-07 |
| 1295208452 | Jeremy Dickerson | Registered Nurse | 1901 Veterans Memorial Dr, Temple, TX 76504-7451 | 2019-01-09 |
| Street Address |
1139 E SONTERRA BLVD STE 205 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78258-4349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639145725 | Stace S Rust | Orthopaedic Surgery | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2006-02-27 |
| 1538619440 | Stone Oak Womens Center | Nurse Practitioner | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2016-10-04 |
| 1922310416 | Sybil Jill Mudloff | Nurse Practitioner | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2010-07-13 |
| 1629307509 | Ryane Marie Cordero | Physician Assistant | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2009-12-23 |
| 1417181967 | Kathryn Swann Holloway | Obstetrics & Gynecology | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2009-05-13 |
| 1093993537 | Stone Oak Womens Center Pa | Obstetrics & Gynecology | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258 | 2008-02-06 |
| 1679785448 | Craig Russell Glauser | Orthopaedic Surgery | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2007-05-04 |
| 1598709305 | Mark M Casillas | Orthopaedic Surgery | 1139 E Sonterra Blvd Ste 205, San Antonio, TX 78258-4349 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1588226211 | New Life Brace and Limb, LLC | Prosthetist | 300 E. Sonterra Blvd., Suite 220, San Antonio, TX 78258 | 2019-07-02 |
| 1720649080 | Miguel Ibarra | Pharmacist | 18866 Stone Oak Pkwy., St.101, San Antonio, TX 78258 | 2019-06-26 |
| 1528538113 | Kevin Scott Farnsworth | Dentist | 1130 E. Sonterra Blvd Suite 100, San Antonio, TX 78258 | 2018-11-27 |
| 1891262176 | Dentists of Stone Oak, PC | Dentist | 23714 Hardy Oak Blvd, Suite 110, San Antonio, TX 78258 | 2018-10-25 |
| 1003399437 | Jesus Alcala | Physical Therapist | 20821 Us Hwy 281 N, Ste 110, San Antonio, TX 78258 | 2018-09-11 |
| 1184106544 | Marissa Kaye Bruton | Occupational Therapist | 505 Madison Oak, San Antonio, TX 78258 | 2018-09-02 |
| 1508346933 | Desiree Carroll | Occupational Therapy Assistant | 18803 Hardy Oak Drive, San Antonio, TX 78258 | 2018-08-15 |
| 1700376456 | Conner Jay Mcnabb | Optometrist | 810 Knights Cross Dr Ste 101, San Antonio, TX 78258 | 2018-05-17 |
| 1982191516 | Freehand Solutions LLC | Chiropractor | Nec Stone Oak Parkway & Loop 1604, San Antonio, TX 78258 | 2018-04-19 |
| Find all providers in zip 78258 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801144522 | Sports Medicine Associates of San Antonio, Pa | Family Medicine | 5921 Broadway St, San Antonio, TX 78209-5235 | 2012-08-28 |
| 1164743621 | Lindsay Page Stephens | Family Medicine | 16403 Huebner Rd, Suite 100, San Antonio, TX 78248-1683 | 2010-06-18 |
| 1245763143 | Ramy Noche | Family Medicine | 11130 Christus Hills, Medical Plaza 3, 3rd Fl, San Antonio, TX 78251-3585 | 2017-04-07 |
| 1740727130 | David R Kling Corporation | Family Medicine | 225 E Sonterra Blvd Ste 113, San Antonio, TX 78258-3993 | 2017-01-24 |
| 1215348404 | Alexandra Stephanie Matthews | Family Medicine | 1139 E Sonterra Blvd Ste 500, San Antonio, TX 78258 | 2014-05-11 |
| 1508202565 | Hugo Pastor Salazar Jr. | Family Medicine | 21 Spurs Ln Ste 300, San Antonio, TX 78240-1679 | 2013-05-17 |
| 1710120126 | Alamo Rehabilitation & Medical Fitness Center LLC | Family Medicine | 2425 Babcock Rd, Suite 111, San Antonio, TX 78229-4898 | 2009-04-15 |
| 1043494032 | Hector Uriel Lopez | Family Medicine | 21 Spurs Ln, Ste 300, San Antonio, TX 78240-1679 | 2007-12-26 |
| 1932383015 | Andrew L. Whaley, M.d., P.a. | Family Medicine | 250 W Sunset Rd, San Antonio, TX 78209-2651 | 2007-12-24 |
| 1861549503 | Sports Medicine Associates of San Antonio, Pa | Family Medicine | 21 Spurs Ln, Ste 300, San Antonio, TX 78240-1679 | 2007-01-04 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78258 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.