Elizabeth P Dykstra, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35225 Issued in TN

Practice address

1620 Westgate Cir
Brentwood, TN 37027-8035

Phone

(629) 255-2095

Fax

(629) 255-4107

NPI assigned

Sep 7, 2005

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

Other identifiers 1

Other names 1

• Elizabeth D Ponder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabethdykstra@hma.allscriptsdirect.net

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.

• Heritage Medical Associates PC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1720042021
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1659365518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 WESTGATE CIR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278035",
            "telephone_number": "629-255-2095",
            "fax_number": "629-255-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "ELIZABETH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "35225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1502891",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PONDER",
            "middle_name": "D",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley M Dunn, MA,SSP,LPC-MHSP (T)
• James E Dunnington, M.D.
• Monica Marie Dunwoodie, PA-C
• Sufeia Yosuf Durani, AGACNP
• Muhammad Hayat Durrani
• Dyslexia Centers of Tennessee, Inc
• Robert P Dziejma, DMD
• Makenna Eadie
• Steven Eagon, MS-CCC-A
• East Nashville Aesthetic Dentistry PLLC

• Pediatrics Physician in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.