Individual provider Active NPI

Larry Laverne Dickey, MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1407999105
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A43175 Issued in CA
Practice address
375 Laguna Honda Blvd
Laguna Honda Hospital and Rehab Center, Medical SVCS
San Francisco, CA 94116-1411
Phone
(415) 759-2300
Fax
(415) 759-4587
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A43175 CA Primary

Addresses

Primary practice location

375 Laguna Honda Blvd
Laguna Honda Hospital and Rehab Center, Medical SVCS
San Francisco, CA 94116-1411

Mailing address

375 Laguna Honda Blvd
Laguna Honda Hospital and Rehab Ctr, Medical SVCS
San Francisco, CA 94116-1411
Phone (415) 759-2300

Other identifiers 1

IdentifierTypeStateIssuer
00A431750MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43175CAMDPharmacist
A43175CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407999105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CTR, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-2300",
            "fax_number": "415-759-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-2300",
            "fax_number": "415-759-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "LARRY",
        "middle_name": "LAVERNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A431750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

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.

Verify at the official NPI Registry.