Active NPI
Elizabeth Bentley Dickard, M.A. CCC-SLP
- Specialist
- Dothan, AL
National Provider Identifier
1366518946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1847
- Practice address
- 430 W Main St
Dothan, AL 36301-1616 - Phone
- (334) 677-6955
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1847 | AL | Primary |
Addresses
Primary practice location
430 W Main St
Dothan, AL 36301-1616
Mailing address
126 Vann Dr
Ashford, AL 36312-3406
Phone (334) 899-3612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1847 | Other | AL | SPEECH THERAPY LICENSE |
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366518946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 VANN DR",
"city": "ASHFORD",
"state": "AL",
"postal_code": "363123406",
"telephone_number": "334-899-3612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W MAIN ST",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363011616",
"telephone_number": "334-677-6955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKARD",
"first_name": "ELIZABETH",
"middle_name": "BENTLEY",
"name_prefix": "Mrs.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AL",
"license": "1847",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH THERAPY LICENSE",
"identifier": "1847",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.