Don R Dickerson, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

6812A Issued in WY

Practice address

803 W Market St Ste 100
Lima, OH 45805-2796

Phone

(419) 996-5063

Fax

(419) 996-5502

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WY, MT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddickerson212052@direct.bsmhealth.org

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.

• Memorial Hospital of Sweetwater County

  dba County of Sweetwater

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Medicare reassignment NPD
• SCL Health Medical Group - Billings LLC

  dba St Vincent Healthcare

  • Clinic/Center
  • Billings, MT
  • NPI 1508289703
  Medicare reassignment NPD
• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Medicare reassignment NPD
• SCL Health Medical Group - Billings, LLC

  dba Billings - DPP (Diabetes Prevention Program)

  • Endocrinology, Diabetes & Metabolism Physician
  • Billings, MT
  • NPI 1003701558
  NPD
• SCL Health Medical Group - Billings, LLC

  dba Heights Clinic - Walk In

  • General Practice Physician
  • Billings, MT
  • NPI 1447866538
  NPD
• SCL Health Montana

  dba Intermountain Health St Vincent Regional Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  NPD
• West Park Hospital District

  • Emergency Medicine Physician
  • Basin, WY
  • NPI 1942921937
  NPD
• Southeast Wyoming Radiation Oncology, P.C.

  • Radiation Oncology Physician
  • Cheyenne, WY
  • NPI 1437259272
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1194825935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 EVANS AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013716",
            "telephone_number": "307-637-5339",
            "fax_number": "307-637-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W MARKET ST STE 100",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052796",
            "telephone_number": "419-996-5063",
            "fax_number": "419-996-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 E 23rd St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820013748",
            "country_code": "US",
            "telephone_number": "307-633-7823",
            "fax_number": "307-633-7818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "DON",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WY",
            "license": "6812A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "312715",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119369400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Derose
• James A Deters, RPH
• Ellen Detrick
• Avery Deweese, RDN, LD
• Tobe C Dick, SWT
• Jamie Lynn Dickman, MOT OTR/L
• Brad William Dietrich Jr., LISW, I.2506324
• Krystal Dawn Dietrich
• Dietz Eye Care & Associates LLC
• Brian E Dietz, O.D.

• Radiation Oncology Physician in Lima, OH
• Providers in Lima, OH by specialty
• Radiation Oncology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.