Barry L Dick, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

29604 Issued in KY

Practice address

580 S Loop Rd
Suite 201
Edgewood, KY 41017-3415

Phone

(859) 344-1600

Fax

(859) 344-0091

NPI assigned

Sep 26, 2005

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Cranley Surgical Associates Inc

  • Surgery Physician
  • Cincinnati, OH
  • NPI 1376518845
  NPD
• St Elizabeth Medical Center, Inc

  • Community/Retail Pharmacy
  • Florence, KY
  • NPI 1104699453
  NPD (past)
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Surgery

  NPD (past)
• Summit Medical Group, Inc.

  dba St. Elizabeth Physicians

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1194711150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHAMBER CENTER DR",
            "address_2": "SUITE 200",
            "city": "LAKESIDE PARK",
            "state": "KY",
            "postal_code": "410171673",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 S LOOP RD",
            "address_2": "SUITE 201",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173415",
            "telephone_number": "859-344-1600",
            "fax_number": "859-344-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "BARRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "29604",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "29604",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "29604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915148",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100354170",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100056850",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01058472",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64933096",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00252704",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vidya Rajaram Devarajan, M.D.
• Dorothy Marie Dewitt, FNP-BC
• Ranbir Singh Dhaliwal, MD
• Harjodh Singh Dhillon, DO
• Darryl D Dias, M.D.
• Mackenzi Dickerson
• Stephi Dickinson, MS, GC
• Timothy Dale Dickinson, MD
• Camryn Joanna Diebold, DPT
• Kendall Diebold, APRN

• Vascular Surgery Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Vascular Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.