Elizabeth Suzan Dykeman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209026921 Issued in IL

Practice address

8021 Watson Rd
Webster Groves, MO 63119-5304

Phone

(866) 389-2727

NPI assigned

Jan 30, 2023

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minuteclinic Diagnostic of Kansas PA

  • Family Nurse Practitioner
  • Leawood, KS
  • NPI 1629005558

  MO

  Medicare reassignment Care Compare group NPD
• Airline Care Clinic PLLC

  • Family Nurse Practitioner
  • East Alton, IL
  • NPI 1992556427
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1063128494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E AIRLINE DR",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241703",
            "telephone_number": "314-374-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8021 WATSON RD",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631195304",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKEMAN",
        "first_name": "ELIZABETH",
        "middle_name": "SUZAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023001205",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dochas Center, LLC
• Gail B Doell, O.D.
• Trisha L Dorries, MSOTR/L
• Sarah Flynn Drayton, MA, RD, LD
• Brooke Dummerth
• Dynamicworks Consulting LLC
• Eanaj Care Home Health LLC
• Edgewood Children's Hom'E
• Destiny Shaunte Eikerenkoetter, OTR
• Alethea Eller, D.C.

• Family Nurse Practitioner in Webster Groves, MO
• Providers in Webster Groves, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.