Active NPI
Mary W. Dickerson, CNM
- Midwife
- Lincoln, NE
National Provider Identifier
1104105709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 120051
- Practice address
- 301 S 70TH St
Suite 200
Lincoln, NE 68510-2469 - Phone
- (402) 483-7641
- Fax
- (402) 483-0527
- NPI assigned
- Aug 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 31542 | NE | |
| Midwife | 176B00000X | 120051 | NE | Primary |
Addresses
Primary practice location
301 S 70TH St
Suite 200
Lincoln, NE 68510-2469
Mailing address
301 S 70TH St
Suite 200
Lincoln, NE 68510-2469
Phone (402) 483-7641
Other names 1
- Mary Williams
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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31542 | NE | MD | Ambulatory Women's Health Care Registered Nurse |
| 120051 | NE | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1104105709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S 70TH ST",
"address_2": "SUITE 200",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102469",
"telephone_number": "402-483-7641",
"fax_number": "402-483-0527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S 70TH ST",
"address_2": "SUITE 200",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102469",
"telephone_number": "402-483-7641",
"fax_number": "402-483-0527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "MARY",
"middle_name": "W.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "NE",
"license": "31542",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "NE",
"license": "120051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "WILLIAMS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.