Dickson Medical Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00033992 Issued in WA

Legal business name

DICKSON MEDICAL CLINIC PLLC

Practice address

500 Front St
Lynden, WA 98264-1923

Phone

(360) 354-4200

Fax

(360) 318-0741

NPI assigned

Mar 22, 2012

Organization subpart

No

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

Authorized official

Name

Caitlin Honcoop

Title

Deputy Office Manager

Phone

(360) 354-4200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David P Dickson, M.D.

  • Family Medicine Physician
  • Lynden, WA
  • NPI 1659327088
  Medicare reassignment Care Compare group NPD
• Mathea Helice Scott, ARNP

  • Adult Health Nurse Practitioner
  • Gig Harbor, WA
  • NPI 1871742635
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1497021547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FRONT ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641923",
            "telephone_number": "360-354-4200",
            "fax_number": "360-318-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FRONT ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641923",
            "telephone_number": "360-354-4200",
            "fax_number": "360-318-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "HONCOOP",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "DEPUTY OFFICE MANAGER",
        "authorized_official_telephone_number": "360-354-4200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00033992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8214876",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alizee Dalton
• Marc Joel Davis, LMP
• Corrine Dejong, LMP
• Jessica Rae Depass, ARNP
• Robert Philip Devries, ACSW
• David P Dickson, M.D.
• DMG Counseling Services PLLC
• Corrie Lynn Doyle, LMP
• Heather Dianne Duffey, LMP, ATC AT/L
• Galen Dunn, LMP

• Family Medicine Physician in Lynden, WA
• Providers in Lynden, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.