Individual provider Active NPI

Isaac Dike

  • Family Nurse Practitioner
  • Freeport, TX
National Provider Identifier
1508227844
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130574 Issued in TX
Practice address
905 N Gulf Blvd
Freeport, TX 77541-3907
Phone
(281) 824-1480
NPI assigned
Mar 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP130574 TX Primary

Addresses

Primary practice location

905 N Gulf Blvd
Freeport, TX 77541-3907

Mailing address

905 N Gulf Blvd
Freeport, TX 77541-3907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170301001551 TX Practitioner - Nurse Practitioner 0648554162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Oct 15, 2016 Accepting new patients
Stephen F Austin Community Health Center,Inc CurrentSince Oct 15, 2016 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

905 N Gulf Blvd
Freeport, TX 77541
Phone (979) 233-6297

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1508227844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N GULF BLVD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775413907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N GULF BLVD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775413907",
            "telephone_number": "281-824-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIKE",
        "first_name": "ISAAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, TX

Sources for this page

Verify at the official NPI Registry.