Shirley Ann Dickinson

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Practice address

1355 State Highway 345
Potsdam, NY 13676-9658

Phone

(315) 322-5584

Fax

(315) 322-5584

NPI assigned

Feb 15, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Shirley a Dickinson

  • Durable Medical Equipment & Medical Supplies
  • Potsdam, NY
  • NPI 1013185545
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1659414829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 STATE HIGHWAY 345",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136769658",
            "telephone_number": "315-322-5584",
            "fax_number": "315-322-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 STATE HIGHWAY 345",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136769658",
            "telephone_number": "315-322-5584",
            "fax_number": "315-322-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565186",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Lee Deleel, L.P.N.
• Margrethe Frank Demers, MHC
• Jackalyn Despaw
• William J Detorres III, MD
• John C Devine, MD
• Brittany N. Disalvo
• Johnathan Mark Domenico, PA-C
• Kelsi Rae Donaldson, MED, BS, ATC
• Loretta Dougan, PT DPT
• Briana Katherine Dow

• Orthotic Fitter in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Orthotic Fitter in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.