Active NPI
Donna Marie Dickson, ARNP-C MSN
- Adult Health Nurse Practitioner
- Trinity, FL
National Provider Identifier
1629246558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2915462
- Practice address
- 1628 Crossvine CT
Trinity, FL 34655-4903 - Phone
- (727) 688-4400
- Fax
- (813) 745-8327
- NPI assigned
- Feb 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2915462 | FL | Primary |
Addresses
Primary practice location
1628 Crossvine CT
Trinity, FL 34655-4903
Mailing address
1628 Crossvine CT
Trinity, FL 34655-4903
Phone (727) 688-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001667500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2915462 | FL | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1629246558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1628 CROSSVINE CT",
"city": "TRINITY",
"state": "FL",
"postal_code": "346554903",
"telephone_number": "727-688-4400",
"fax_number": "813-745-8327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1628 CROSSVINE CT",
"city": "TRINITY",
"state": "FL",
"postal_code": "346554903",
"telephone_number": "727-688-4400",
"fax_number": "813-745-8327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "DONNA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "ARNP-C MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "2915462",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001667500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Trinity, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.