NPIMap

Organization Active NPI

Dickson Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Dickson, TN
National Provider Identifier
1356444699
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DICKSON MEDICAL ASSOCIATES, PC
Practice address
114 Highway 70 E
Dickson, TN 37055-7030
Phone
(615) 441-4530
Fax
(615) 446-1357
NPI assigned
Sep 5, 2006
Organization subpart
Yes
Parent organization
DICKSON MEDICAL ASSOCIATES, PCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Miss Cindy A Lighthill
Title
Executive Director
Phone
(615) 441-4477

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031204000828 TN Part B Supplier - Clinic/Group Practice 3971408774 Receives reassigned benefits from 58 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Bluff, TN; Waverly, TN; Hohenwald, TN; Fairview, TN; Dickson, TN; Clarksville, TN

National Provider Directory

National Provider Directory
Part of
Jackson Clinic Prof Ass

Locations

114 Highway 70 E
Dickson, TN 37055
Phone (615) 441-4530

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Community Health Clinic/Center 261QC1500X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

114 Highway 70 E
Dickson, TN 37055-7030

Mailing address

127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
3158185OtherTNBCBS TN GROUP PIN
CH3856OtherRAILROAD MEDICARE PIN
3721355MedicaidTN

Other names 1

NPPES NPI Registry
  • DMA Childrens Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 24, 2021.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1356444699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HIGHWAY 70 E",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370557030",
            "telephone_number": "615-441-4530",
            "fax_number": "615-446-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "enumeration_date": "2006-09-05",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "LIGHTHILL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "615-441-4477",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN GROUP PIN",
            "identifier": "3158185",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CH3856",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721355",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMA Childrens Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.