DR. STEPHEN L DICKSON JR. (NPI# 1720086242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720086242 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN L DICKSON JR. |
| Credential | MD |
| Practice Address |
2500 Niles Rd Ste 6 Saint Joseph MI 49085-3268 |
| Mailing Address |
1234 Napier Ave Saint Joseph MI 49085-2112 |
| Practice Telephone | 2694081660 |
| Practice Fax Number | 2694081665 |
| Mailing Telephone | 2699838172 |
| Mailing Fax Number | 6998545352 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4301114501 | MI | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 43991 | KY | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 01058168A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64076821 | 05 | |
| KY | HUMANA- CTS | 000057094V | 01 |
| IN | 200455130A | 05 | |
| KY | CIGNA- CTS | 4001605 | 01 |
| KY | PASSPORT- CTS | 50031859 | 01 |
| IN | 200455130 | 05 | |
| KY | ANTHEM- CTS | 000000701004 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3 Audubon Plaza Dr Ste 1319, Louisville, KY 402171319 | 5026368004 | 5026368384 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023422474 | Stephen Dickson | Internal Medicine | 19550 E 39th St S Ste 215, Independence, MO 64057-2326 | 2014-06-13 |
| Street Address |
2500 NILES RD STE 6 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-3268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679587596 | Lakeshore Cardiothoracic and Vascular Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2500 Niles Rd Ste 6, Saint Joseph, MI 49085-3268 | 2006-07-28 |
| 1619969243 | Troy Teagardin | Physician Assistant | 2500 Niles Rd Ste 6, Saint Joseph, MI 49085-3268 | 2005-08-19 |
| 1366434987 | Kourosh Baghelai | Surgery | 2500 Niles Rd Ste 6, Saint Joseph, MI 49085-3268 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427069855 | Denis P Raleigh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 802 N Riverside Rd Ste 210, Saint Joseph, MO 64507-2509 | 2006-08-10 |
| 1245591650 | Juan Carlos Geronimo Adames | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 802 N Riverside Rd Ste 210, Saint Joseph, MO 64507-2509 | 2012-06-01 |
| 1679587596 | Lakeshore Cardiothoracic and Vascular Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2500 Niles Rd Ste 6, Saint Joseph, MI 49085-3268 | 2006-07-28 |
| 1942228879 | Jane L. Schwabe | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 802 N Riverside Rd, Suite 210, Saint Joseph, MO 64507-9794 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710479191 | United Surgical Associates Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2150 Association Dr, Okemos, MI 48864-4909 | 2018-06-01 |
| 1841719531 | Liberty Cardiolvascular Group Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5250 Auto Club Dr Ste 300l, Dearborn, MI 48126-2619 | 2017-09-13 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1871982249 | Michigan Heart Lung and Vein Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2757 Leonard Ne, Ste 200, Grand Rapids, MI 49525-5807 | 2015-01-22 |
| 1154767382 | Michigan Thoracic Institute, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6640 Kings Ct, West Bloomfield, MI 48322-2779 | 2013-05-15 |
| 1679815898 | Hanna Park | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Rm 8830, Grand Rapids, MI 49503 | 2013-03-26 |
| 1760730469 | Hurley Medical Center | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1125 S. Linden Road, Suite 700, Flint, MI 48532-4069 | 2012-08-28 |
| 1245588326 | Bakri Kaakeh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4701 Towne Centre Rd Ste 301, Saginaw, MI 48604-2800 | 2012-08-21 |
| 1447521554 | Eduardo Arciniegas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3236 Interlaken St, West Bloomfield, MI 48323-1824 | 2012-01-20 |
| 1629358650 | Steven S. Demos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3739 Highgate Rd, Norton Shores, MI 49441-5017 | 2011-08-22 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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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.