MR. DAVID CARROLL DICKSON (NPI# 1134246895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134246895 |
| Entity Type | Individual |
| Full Name | MR. DAVID CARROLL DICKSON |
| Credential | 1.CERTIFIED PEDORTHI |
| Practice Address |
612 W. Sheridan Avenue Shenandoah IA 51601 |
| Mailing Address |
612 W. Sheridan Avenue Jay Drug C. (dcd Pedorthics) Shenandoah IA 51601 |
| Practice Telephone | 7122462635 |
| Practice Fax Number | 7122463933 |
| Mailing Telephone | 7122462635 |
| Mailing Fax Number | 7122463933 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224L00000X | Pedorthist | 074625 | IA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 547455800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952588436 | David P Dickson | Counselor | 1318 Florida Blvd, Suite A, Denham Springs, LA 70726-4600 | 2008-01-27 |
| 1659327088 | David P Dickson | Family Medicine | 500 Front St, Lynden, WA 98264-1923 | 2006-05-26 |
| 1811428444 | David M Dickson | Perfusionist | 31330 Schoolcraft Rd, Ste 200, Livonia, MI 48150-2041 | 2017-03-24 |
| 1952658684 | David Ludwick Dickson | Pharmacist | 12645 S Virginia St, Reno, NV 89511-4803 | 2012-08-13 |
| 1720138043 | David Dickson | Technician | 31950 Clark St, Apt 1, New Haven, MI 48048-1934 | 2007-01-11 |
| 1063482545 | David Gordon Dickson | Specialist | 435 South St, Suite 100, Morristown, NJ 07960-6422 | 2006-01-25 |
| 1568443026 | David P. Dickson | Optometrist | 553 E Town St, Columbus, OH 43215-4856 | 2005-11-10 |
| Street Address |
612 W. SHERIDAN AVENUE |
| City | SHENANDOAH |
| State | IA |
| Zip Code | 51601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336589969 | Jenifer Ann Deziel | Nurse Practitioner | Shenandoah Medical Center, 300 Pershing Avenue, Shenandoah, IA 51601 | 2013-06-27 |
| 1154621282 | Md West One, PC | Neurological Surgery | 1 Jack Foster Drive, Shenandoah, IA 51601 | 2010-10-22 |
| 1912119124 | Swfac Plc | Podiatrist | 813 Church St., Shenandoah, IA 51601 | 2007-05-03 |
| 1558433037 | Joseph Patrick Emge | Dentist | 301 Maple St, Suite 3, Shenandoah, IA 51601 | 2006-11-14 |
| 1487766309 | Scott Richard King | Obstetrics & Gynecology | 300 Pershing Avenue, Shenandoah, IA 51601 | 2006-08-31 |
| 1801904933 | Marvin E Belknap | Dentist | 617 West Thomas, Shenandoah, IA 51601 | 2006-08-28 |
| 1083687636 | Charles J Peterson Dc PC | Chiropractor | 1203 W Sheridan Ave, Shenandoah, IA 51601 | 2006-02-13 |
| 1467692152 | Carol A Stehlik | Nutritionist | 300 Pershing Avenue, Shenandoah, IA 51601-0382 | 2009-02-20 |
| 1265526248 | Nishna Productions, Inc. | Community/Behavioral Health | 902 Day St, Shenandoah, IA 51601-1106 | 2006-10-03 |
| 1124105192 | Nishna Productions, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Day St, Shenandoah, IA 51601-1106 | 2006-11-01 |
| Find all providers in zip 51601 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356693428 | Hal Lewis Mead | Pedorthist | 6750 Westown Pkwy, Suite 200 #360, West Des Moines, IA 50266-5026 | 2012-10-12 |
| City | SHENANDOAH |
| Zip Code | 51601 |
Please comment or provide details below to improve the information on MR. DAVID CARROLL DICKSON.
| 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.