Kimberly Dawn Dyckman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6644 Issued in GA

Practice address

1100 Northside Forsyth Dr
Suite 200
Cumming, GA 30041-6012

Phone

(770) 887-2323

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, MT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SCL Health Medical Group - Billings LLCGroup PAC ID 9638491574, 291 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Compassus Home Health - Billings Home health agency, Billings, MT, CCN 277068
• Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdyckman38052@direct.emory.org

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.

• SCL Health Medical Group - Billings LLC

  dba St Vincent Healthcare

  • Clinic/Center
  • Billings, MT
  • NPI 1508289703
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment
• SCL Health Medical Group - Billings, LLC

  dba Billings - DPP (Diabetes Prevention Program)

  • Endocrinology, Diabetes & Metabolism Physician
  • Billings, MT
  • NPI 1003701558
  NPD
• Lanier Family Practice

  • Family Medicine Physician
  • Cumming, GA
  • NPI 1063635613
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rocky Mountain Home Care II, LLC

  dba Compassus Home Health Billings MT

  • Home Health Agency
  • Billings, MT
  • NPI 1659690535
  Care Compare affiliation
• SCL Health Montana

  dba Intermountain Health St Vincent Regional Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Care Compare affiliation
• St. Vincent Healthcare

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1396916276
  Care Compare affiliation

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1598009557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DRIVE",
            "address_2": "ST 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-887-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DR",
            "address_2": "SUITE 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416012",
            "telephone_number": "770-887-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCKMAN",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Dusseau, OTRL
• Dva Renal Healthcare Inc (Cumming Dialysis)
• Katherine Lynn Dwozan, PT, DPT
• Cody Michael Dwyer
• Dyad Care, LLC (Dyad Wellness)
• Gregory Ryan Dykes, D.C.
• Mary Elizabeth Eaccarino, M.D.
• Ashley Eades
• Earl Rineys, Inc. (Senior Helpers of Northeast Atlanta)
• Raymond E. Easley, D.O.

• Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.