Mark Rayner Dickey, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4034 Issued in TX

Practice address

4405 Guadalupe St
Austin, TX 78751-3616

Phone

(512) 452-3000

Fax

(512) 452-3004

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1326118183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 GUADALUPE ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787513616",
            "telephone_number": "512-452-3000",
            "fax_number": "512-452-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 GUADALUPE ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787513616",
            "telephone_number": "512-452-3000",
            "fax_number": "512-452-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "MARK",
        "middle_name": "RAYNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyrion Dickerson
• Sydney Dickerson, LCSW-S
• Alexis Dickey, LPC ASSOCIATE
• Elizabeth C Dickey
• Katerina Sheffield Dickey, D.C., RPH
• Sherry Elizabeth Dickey, PH.D.
• Tahra Dickey, SLP
• Paley Elizabeth Dickison
• Sharon S. Dickmann, MPT
• Haylie Dickson

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.