David P Dickerson, D. C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4127 Issued in OK

Practice address

3705 N Harrison St
Shawnee, OK 74804-2223

Phone

(405) 273-6822

Fax

(888) 413-2901

NPI assigned

Dec 29, 2006

Last updated

Apr 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chiropractic Health and Acupuncture Clinic

  • Chiropractor
  • Shawnee, OK
  • NPI 1487221776
  NPD Authorized official
• Chiropractic Health Clinic

  • Chiropractor
  • Shawnee, OK
  • NPI 1649588096
  Authorized official Same address or phone
• Salida Family Chiropractic

  • Medical Specialty Clinic/Center
  • Salida, CO
  • NPI 1649786583
  NPD (past)
• Springs Chiropractic Health, Inc.

  • Chiropractor
  • Colorado Springs, CO
  • NPI 1003209206
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1396801692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 N HARRISON ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042223",
            "telephone_number": "405-273-6822",
            "fax_number": "888-413-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 N HARRISON ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042223",
            "telephone_number": "405-273-6822",
            "fax_number": "888-413-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 G St",
            "address_purpose": "LOCATION",
            "city": "Salida",
            "state": "CO",
            "postal_code": "812012035",
            "country_code": "US",
            "telephone_number": "719-539-4398",
            "fax_number": "888-413-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2916",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY",
            "identifier": "C26033",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.