Susan M Dimick, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15279 Issued in OK

Practice address

3317 E Memorial Rd
Suite 103
Edmond, OK 73013-7105

Phone

(405) 475-0100

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2010 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1083663611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 E MEMORIAL RD STE 103",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730137095",
            "telephone_number": "405-475-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 E MEMORIAL RD",
            "address_2": "SUITE 103",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730137105",
            "telephone_number": "405-475-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMICK",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "15279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Dietrich
• Digestive Health Nutrition LLC
• Shannon Lee Digiovanni
• Aaron Kyle Dill, DPT
• Daisha J Dillard
• Direct Care Medical Group, PLLC
• Directed Steps Counseling Center PLLC
• Discovery Wellness LLC
• Robert Distefano, PT
• Jordan Divilbiss, M.A., CCC-SLP

• Family Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.