DAVID D DYCK JR. (NPI# 1649231051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649231051 |
| Entity Type | Individual |
| Full Name | DAVID D DYCK JR. |
| Credential | D.O. |
| Practice Address |
19550 E 39th St S Suite 419 Independence MO 64057-2303 |
| Practice Telephone | 8167958200 |
| Practice Fax Number | 8167957735 |
| Mailing Telephone | 8167958200 |
| Mailing Fax Number | 8167957735 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2009-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
108810 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100396370C | 05 | |
| KS | 100396370B | 05 | |
| MO | RAILROAD MEDICARE | 080135929 | 01 |
| MO | 1649231051 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053303479 | David M Dyck | Family Medicine | 3301 County Road 6 E, Elkhart, IN 46514-7673 | 2005-08-22 |
| Street Address |
19550 E 39TH ST S SUITE 419 |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64057-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031909 | Nathan T. Wegner | Specialist | 19550 E 39th St S, Suite 310, Independence, MO 64057-2303 | 2005-05-24 |
| 1013451558 | Courtney Adams | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2358 | 2016-12-16 |
| 1154878122 | Long and Associates Pain Therapy Inc | General Practice | 19550 E 39th St S, Suite 235, Independence, MO 64057-2358 | 2016-09-07 |
| 1952755340 | Christina Turner | Nurse Practitioner | 19550 E 39th St S, Suite 220, Independence, MO 64057-2358 | 2016-04-21 |
| 1417301615 | Allyson Marie Williams | Nurse Practitioner | 19550 E 39th St S, Ste 410, Independence, MO 64057-2358 | 2016-04-14 |
| 1962860684 | Melody L Alexander | Nurse Practitioner | 19550 E 39th St S, Suite 315, Independence, MO 64057-2358 | 2016-02-09 |
| 1124492608 | Tracy Giese | Nurse Practitioner | 19550 E 39th St S, Suite 245, Independence, MO 64057-2358 | 2015-11-20 |
| 1356733638 | Carma Elizabeth Ball | Nurse Practitioner | 19550 E 39th St S, Suite 200, Independence, MO 64057-2303 | 2015-02-24 |
| 1508257544 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 19550 E 39th St S, Suite 100, Independence, MO 64057-2303 | 2015-02-12 |
| 1851706022 | Leslie Peirce | Registered Nurse | 19550 E 39th St S, Suite 100, Independence, MO 64057-2358 | 2014-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174002364 | Justine Barye Bolton | Physical Therapist | 2301 South 291 Highway, Independence, MO 64057 | 2018-08-09 |
| 1194230136 | Brantley Vincent Niendick | Occupational Therapist | 2301 S M 291 Hwy, Independence, MO 64057 | 2017-12-13 |
| 1437693561 | Derek Faulkner | Counselor | 2400 Little Blue Pkwy, Independence, MO 64057 | 2016-12-08 |
| 1578916136 | Jared Donald Gerstenkorn | Physical Therapist | 2301 South Highway 291, Independence, MO 64057 | 2016-07-19 |
| 1295198182 | Jennifer J Allen | Nurse Practitioner | 2310 Castle Drive, Independence, MO 64057 | 2016-03-30 |
| 1750750808 | Lisa Louise Freeman | Physical Therapy Assistant | 3980 S Jackson Dr, Independence, MO 64057 | 2015-09-18 |
| 1437543592 | Harold Epps | Specialist/Technologist | 2301 South Mo 291 Highway, Independence, MO 64057 | 2015-03-26 |
| 1245620426 | Holly Morgan | Occupational Therapist | 3980 S Jackson Dr., Independence, MO 64057 | 2015-01-27 |
| 1093128159 | Jennifer Falk Crumbaugh | Dentist | 3151 S. M-291 Highway, Suite A, Independence Mo, MO 64057 | 2014-06-06 |
| 1952711954 | Judy Bray | Occupational Therapy Assistant | 3980 East Jackson Drive, Independence, MO 64057 | 2014-04-30 |
| Find all providers in zip 64057 | ||||
| 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 |
|---|---|---|---|---|
| 1871105312 | 417 Sports Medicine and Orthopedics LLC | Family Medicine | 330 W Plainview Rd Ste F, Springfield, MO 65810-2672 | 2020-08-17 |
| 1871115857 | Ben Heimos | Family Medicine | 1 S Compton Ave, Saint Louis, MO 63103-2001 | 2020-05-12 |
| 1639645070 | Bluetail Biologics LLC | Family Medicine | 17300 N Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2018-10-23 |
| 1083096671 | Daniel O'loughlin | Family Medicine | 1605 Martin Springs Dr Ste 330, Rolla, MO 65401-2980 | 2015-06-19 |
| 1295175057 | Devin Willis | Family Medicine | 16555 Manchester Rd Ste 100, Wildwood, MO 63040 | 2013-06-26 |
| 1922377274 | Duocorp Enterprises, LLC | Family Medicine | 1525 E Republic Rd, Suite A115, Springfield, MO 65804-6527 | 2011-12-15 |
| 1689960171 | Nathan Lee Granneman | Family Medicine | 200 Corporate Lake Dr, Columbia, MO 65203-7172 | 2011-06-22 |
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1922116763 | Kristin Suzanne Oliver | Family Medicine | 17300 North Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2006-08-29 |
| 1942238027 | John J Dougherty | Family Medicine | 1010 Carondelet Dr Ste 220, Kansas City, MO 64114-4822 | 2006-06-29 |
| Find all providers with the same taxonomy | ||||
| City | INDEPENDENCE |
| Zip Code | 64057 |
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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.