Individual provider Active NPI

Dickie Lynn Hill, D.O.

  • Family Medicine Physician
  • Benicia, CA
National Provider Identifier
1093844649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A4946 Issued in CA
Practice address
821 E 2ND St
Suite 104
Benicia, CA 94510-3344
Phone
(707) 745-3785
Fax
(707) 746-1770
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A4946 CA Primary

Addresses

Primary practice location

821 E 2ND St
Suite 104
Benicia, CA 94510-3344

Mailing address

821 E 2ND St
Suite 104
Benicia, CA 94510-3344
Phone (707) 745-3785

Other identifiers 1

IdentifierTypeStateIssuer
0631402OtherCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A4946CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093844649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E 2ND ST",
            "address_2": "SUITE 104",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103344",
            "telephone_number": "707-745-3785",
            "fax_number": "707-746-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E 2ND ST",
            "address_2": "SUITE 104",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103344",
            "telephone_number": "707-745-3785",
            "fax_number": "707-746-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "DICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "0631402",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benicia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.