Organization Active NPI

Christian M Dickson, DPM, PA

  • Foot & Ankle Surgery Podiatrist
  • Corpus Christi, TX
National Provider Identifier
1083693907
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1463 Issued in TX
Legal business name
CHRISTIAN M DICKSON, DPM, PA
Practice address
5920 Saratoga Blvd
Suite 600 B
Corpus Christi, TX 78414-4104
Phone
(361) 993-4230
Fax
(361) 993-5680
NPI assigned
Jan 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Mrs. Marie Dickson
Title
Administrator
Phone
(361) 993-4230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 1463 TX Primary

Addresses

Primary practice location

5920 Saratoga Blvd
Suite 600 B
Corpus Christi, TX 78414-4104

Mailing address

5920 Saratoga Blvd
Suite 600 B
Corpus Christi, TX 78414-4104
Phone (361) 993-4230

Other identifiers 1

IdentifierTypeStateIssuer
181572201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060818000431 TX Part B Supplier - Clinic/Group Practice 6608879317 Receives reassigned benefits from 1 practitioner
Practice locations: Corpus Christi, TX
O20100930060225 TX DME Supplier - Physician - Podiatry 6608879317 Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

5920 Saratoga Blvd
Ste 600B
Corpus Christi, TX 78414
Phone (361) 993-4230

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1083693907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 SARATOGA BLVD",
            "address_2": "SUITE 600 B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144104",
            "telephone_number": "361-993-4230",
            "fax_number": "361-993-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 SARATOGA BLVD",
            "address_2": "SUITE 600 B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144104",
            "telephone_number": "361-993-4230",
            "fax_number": "361-993-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN M DICKSON, DPM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "361-993-4230",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181572201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.