Kimberly K Sheker-Dickson, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A7995 Issued in CA

Practice address

1628 Palm Ave
San Diego, CA 92154-1027

Phone

(619) 591-9999

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kimberly S Dickson Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

College of Osteo Med of the Pacific at Pomona, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southbay Urgent Care IncGroup PAC ID 6406166339, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Southbay Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1558746750
  Medicare reassignment Care Compare group NPD Authorized official
• KM Dickson Medical Corporation

  • General Practice Physician
  • San Diego, CA
  • NPI 1265642250
  Medicare reassignment NPD
• Dr Carneiro Wound Medicine Corp

  • Primary Care Clinic/Center
  • San Diego, CA
  • NPI 1942983473
  NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1194755363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 PALM AVE BAY URGENT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541027",
            "telephone_number": "619-591-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541027",
            "telephone_number": "619-591-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKER-DICKSON",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "4055",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A7995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "867640",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CB244891",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XPY199939",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DICKSON",
            "middle_name": "S",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karla Equihua Sheikh
• Nazneen Ajaz Sheikh
• Zara Shakoor Sheikh, MD
• Catherine Ruth Sheils, MD
• Boris Sheinin, PSY.D.
• Bahtyah Shekina
• Danielle Shelby
• Katherine Rose Shelby
• Elizabeth Sheldon
• Jamie Sheldon, PT

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.