Active NPI
Michael D. Dick, M.D.
- Internal Medicine Physician
- Decatur, AL
National Provider Identifier
1467514026
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Nov 19, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21873
- Practice address
- 2828 Highway 31 S
Decatur, AL 35603-1510 - Phone
- (256) 306-1330
- Fax
- (256) 306-1335
- NPI assigned
- Dec 13, 2006
- Last updated
- Mar 18, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21873 | AL | Primary |
| Rheumatology Physician | 207RR0500X | 21873 | AL |
Addresses
Primary practice location
2828 Highway 31 S
Decatur, AL 35603-1510
Mailing address
PO Box 5250
Decatur, AL 35601-0250
Phone (256) 306-1330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51541597 | Other | AL | BLUE CROSS BLUE SHIELD |
| 51541598 | Other | AL | BLUE CROSS BLUE SHIELD |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21873 | AL | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Imaging Partners LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Decatur, AL
- NPI 1871817072
-
- Contractor
- Jasper, AL
- NPI 1538244439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1467514026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5250",
"city": "DECATUR",
"state": "AL",
"postal_code": "356010250",
"telephone_number": "256-306-1330",
"fax_number": "256-306-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 HIGHWAY 31 S",
"city": "DECATUR",
"state": "AL",
"postal_code": "356031510",
"telephone_number": "256-306-1330",
"fax_number": "256-306-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICK",
"first_name": "MICHAEL",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "21873",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "AL",
"license": "21873",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51541597",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51541598",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.