Individual provider Active NPI

Elizabeth L Dickens, CNM

  • Advanced Practice Midwife
  • Flower Mound, TX
National Provider Identifier
1174529598
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
536369 Issued in TX
Practice address
2980 Long Prairie Rd
Suite E
Flower Mound, TX 75022-4845
Phone
(972) 899-9787
Fax
(972) 899-9786
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 536369 TX Primary

Addresses

Primary practice location

2980 Long Prairie Rd
Suite E
Flower Mound, TX 75022-4845

Mailing address

2980 Long Prairie Rd
Suite E
Flower Mound, TX 75022-4845
Phone (972) 899-9787

Other identifiers 2

IdentifierTypeStateIssuer
8Y8646OtherBLUE CROSS BLUE SHIELD OF TEXAS
141996203MedicaidTX

Other names 1

  • Elizabeth L Rodgers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090102000338 TX Practitioner - Certified Nurse Midwife (CNM) 7416019245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey G Van Dell, MD, PA, PLLC Advanced Practice Midwife CurrentSince Jan 16, 2010 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1174529598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 LONG PRAIRIE RD",
            "address_2": "SUITE E",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224845",
            "telephone_number": "972-899-9787",
            "fax_number": "972-899-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 LONG PRAIRIE RD",
            "address_2": "SUITE E",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224845",
            "telephone_number": "972-899-9787",
            "fax_number": "972-899-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "536369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "8Y8646",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141996203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "RODGERS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.