Individual provider Active NPI

Edward Lewis Dick, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1700919578
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L3281 Issued in TX
Practice address
1406 Fitch St
San Antonio, TX 78211-1406
Phone
(210) 922-6922
NPI assigned
Mar 13, 2007
Last updated
Jul 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L3281 TX Primary
Family Medicine Physician 207Q00000X 18994 OK
Pediatrics Physician 208000000X L3281 TX

Addresses

Primary practice location

1406 Fitch St
San Antonio, TX 78211-1406

Mailing address

1406 Fitch St
San Antonio, TX 78211-1406
Phone (210) 922-6922

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18994OKMDFamily Medicine Physician
L3281TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Health System Past Accepting new patients
Methodist Healthcare Ministries of South Texas Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: edward.dickmd.p1@direct.mhm.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1700919578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 FITCH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782111406",
            "telephone_number": "210-922-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 FITCH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782111406",
            "telephone_number": "210-922-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "EDWARD",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3281",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "18994",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L3281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.