Rex Dickerson, D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

9558 Issued in TX

Practice address

103 Goehmann LN
Fredericksburg, TX 78624-5307

Phone

(830) 990-1660

Fax

(830) 990-1407

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Rex Dickerson Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1568465631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GOEHMANN LN",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245307",
            "telephone_number": "830-990-1660",
            "fax_number": "830-990-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GOEHMANN LN",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245307",
            "telephone_number": "830-990-1660",
            "fax_number": "830-990-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "REX",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "TX",
            "license": "9558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC & BS PROVIDER NUMBER",
            "identifier": "608126",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REX",
            "last_name": "DICKERSON",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cameron B Culver, M.D.
• Marshall Wade Cunningham, MD
• Rebecca Wendall Daley, D.O.
• Daniel B Robertson MD PA
• Brent Kyle Denny, DPT
• Traci Doerre
• Roy E Donathen, RPH
• Dr. Jason N. Peet, M.D., P.a.
• Jennifer Woerner Dulaney, MD
• Richard M Dulaney, M.D.

• Nutrition Chiropractor in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Nutrition Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.