NPIMap

Organization Active NPI

Dickson Medical Associates, PC

Doing business as DMA Childrens Clinic

  • 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
Doing business as
DMA Childrens Clinic
Practice address
114 Highway 70 E
Dickson, TN 37055-7030
Phone
(615) 441-4530
Fax
(615) 446-1357
NPI assigned
Sep 5, 2006
Last updated
Aug 24, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DICKSON MEDICAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Authorized official

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

Specialties & licenses 3

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

Addresses

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 names 1

  • DMA Childrens Clinic Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Part of
Dickson Medical Associate PC

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

113 Highway 70 E
Dickson, TN 37055
Phone (615) 446-5121

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "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": [],
    "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.