NPIMap

Organization Active NPI

Mary Curry Dickerson, MD, LLC

  • Dermatology Physician
  • Zachary, LA
National Provider Identifier
1598948945
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
200824 Issued in LA
Legal business name
MARY CURRY DICKERSON, MD, LLC
Practice address
20474 Old Scenic Hwy
Zachary, LA 70791-7300
Phone
(225) 654-1124
Fax
(225) 654-7079
NPI assigned
Dec 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Dr. Mary Curry Dickerson, MD
Title
Owner
Phone
(225) 654-1124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 200824 LA Primary

Addresses

Primary practice location

20474 Old Scenic Hwy
Zachary, LA 70791-7300

Mailing address

2561 Citiplace CT
Suite 750-156
Baton Rouge, LA 70808-2722

Other identifiers 1

IdentifierTypeStateIssuer
4603970650OtherLABLUE CROSS

National Provider Directory

National Provider Directory

Locations

2561 Citiplace Ct
Ste 750156
Baton Rouge, LA 70808

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1598948945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 CITIPLACE CT",
            "address_2": "SUITE 750-156",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708082722",
            "fax_number": "225-201-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20474 OLD SCENIC HWY",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707917300",
            "telephone_number": "225-654-1124",
            "fax_number": "225-654-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY CURRY DICKERSON, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CURRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-654-1124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "LA",
            "license": "200824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4603970650",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.