MARIO S. DICKENS (NPI# 1902843154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902843154 |
| Entity Type | Individual |
| Full Name | MARIO S. DICKENS |
| Credential | DPM |
| Practice Address |
6116 Shallowford Rd Ste 118 Chattanooga TN 37421-7201 |
| Practice Telephone | 4237101224 |
| Practice Fax Number | 4237101228 |
| Mailing Telephone | 4237101224 |
| Mailing Fax Number | 4237101228 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2015-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 690 | TN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1512827 | 05 | |
| MI | 4342355 | 05 | |
| RAILROAD MEDICARE | P00744501 | 01 |
| Street Address |
6116 SHALLOWFORD RD STE 118 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-7201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780135731 | Tamera Rost | Behavioral Analyst | 6116 Shallowford Rd, Suite 201, Chattanooga, TN 37421-7201 | 2016-10-14 |
| 1205113891 | Elite Behavior Analysis, LLC | Behavioral Analyst | 6116 Shallowford Rd, Suite 201, Chattanooga, TN 37421-7201 | 2011-11-09 |
| 1023252012 | Comfort Foot Care LLC | Podiatrist | 6116 Shallowford Rd, Ste 118, Chattanooga, TN 37421-7201 | 2009-04-22 |
| 1538313853 | Personalized Healthcare for Women LLC | Advanced Practice Midwife | 6116 Shallowford Rd, Suite 117, Chattanooga, TN 37421-7201 | 2008-11-13 |
| 1003954595 | Beverly J Jacks | Nurse Practitioner | 6116 Shallowford Rd, Suite 117, Chattanooga, TN 37421-7201 | 2007-02-05 |
| 1124059407 | Guardian Home Care, LLC | Home Health | 6116 Shallowford Rd, Suite 114, Chattanooga, TN 37421-7201 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780072371 | Special Care Podiatry of Tennessee, LLC | Podiatrist | 6140 E Brainerd Rd, Chattanooga, TN 37421-3910 | 2015-01-05 |
| 1992048938 | Advanced Foot Care, LLP | Podiatrist | 3742 Tennessee Ave, Suite 108, Chattanooga, TN 37409-1215 | 2013-03-28 |
| 1215166384 | Joy Danae Russell | Podiatrist | 5701 Brainerd Rd, Suite 111, Chattanooga, TN 37411-4016 | 2009-07-09 |
| 1740334325 | Cynthia Smallman Eby | Podiatrist | 4512 Dayton Blvd, Chattanooga, TN 37415-2148 | 2007-01-22 |
| 1598853970 | Michael Todd Wiles | Podiatrist | 5959 Shallowford Rd Ste 213, Chattanooga, TN 37421-2215 | 2006-10-10 |
| 1932118643 | Robert G. Walters | Podiatrist | 1720 Gunbarrel Rd Ste 204, Chattanooga, TN 37421-3192 | 2006-08-05 |
| 1316969215 | Rivercity Podiatry, PC | Podiatrist | 3107 Ozark Cir, Chattanooga, TN 37415-5105 | 2006-07-23 |
| 1063479350 | Dennis Luke Bizzoco | Podiatrist | 1007 Spring Creek Rd, Chattanooga, TN 37412 | 2006-04-28 |
| 1780683136 | David Q Anderson | Podiatrist | 3742 Tennessee Ave Ste 108, Chattanooga, TN 37409 | 2005-07-19 |
| 1417314477 | Sam Bazrafshan | Podiatrist | 4308 Brainerd Rd, Chattanooga, TN 37411 | 2016-01-21 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on MARIO S. DICKENS.
| 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.