Scott D Dickson, D.O.
Individual provider Active NPI Allergy Physician · Logan, UT
NPI 1467576322 · NPPES record last updated Sep 8, 2021
Key facts
- NPI
- 1467576322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy Physician 207KA0200X
- License
- 9291183-1204 (UT)
- Practice address
- 1350 N 500 E
Logan, UT 84341-2400 - Phone
- (435) 716-1820
- Fax
- (435) 716-1693
- NPI assigned
- Mar 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Allergy/Immunology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1350 N 500
Logan, UT 84341-2400
Phone (435) 716-1770
Hospital & facility affiliations
- Intermountain Health Logan Regional Hospital
- Bear River Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150521001419 | UT | Practitioner - Allergy/Immunology | 7911141478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9291183-1204 | UT | MD | Allergy Physician |
| 02003323A | IN | MD | Pediatrics Physician |
| 58.002130 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 02003323A | IN | |
| Pediatrics Physician | 208000000X | 58.002130 | OH | |
| Allergy Physician | 207KA0200X | 9291183-1204 | UT | Yes |
Addresses
Primary practice location
1350 N 500 E
Logan, UT 84341-2400
Mailing address
1350 N 500 E
Logan, UT 84341-2400
Phone (435) 716-1820
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | scott.dickson@direct.imail.org |
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.