Active NPI
Caiden Dicke
- Athletic Trainer
- Fort Wayne, IN
National Provider Identifier
1316570898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 10627 Diebold Rd
Fort Wayne, IN 46845-8606 - Phone
- (260) 470-2700
- NPI assigned
- Feb 12, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
10627 Diebold Rd
Fort Wayne, IN 46845-8606
Mailing address
6247 Saint Joe Rd # 204B
Fort Wayne, IN 46835-2007
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manchester University College of Pharmacy | Past | 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.
-
- Primary Care Clinic/Center
- Fort Wayne, IN
- NPI 1285010579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1316570898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6247 SAINT JOE RD # 204B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468352007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10627 DIEBOLD RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468458606",
"telephone_number": "260-470-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKE",
"first_name": "CAIDEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.