Individual provider Active NPI

Catherine K Dickens, M.D.

  • Family Medicine Physician
  • Pooler, GA
National Provider Identifier
1770670259
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35240 Issued in GA
Practice address
107 Canal St
Pooler, GA 31322-4016
Phone
(912) 355-6221
NPI assigned
Oct 6, 2006
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35240 GA Primary

Addresses

Primary practice location

107 Canal St
Pooler, GA 31322-4016

Mailing address

5 Azalia Dr
Statesboro, GA 30458-4908
Phone (912) 681-3040

Other practice location 1

0404 Forrest Dr
Georgia Southern University Health Services
Statesboro, GA 30460-0001
Phone (912) 681-0312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL, ND3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040308000374 GA Practitioner - Family PracticePractitioner - Emergency Medicine 3577451012 Reassigns benefits to 11 organizations
I20190326001370 AL Practitioner - HospitalistPractitioner - Emergency Medicine 3577451012 Reassigns benefits to 2 organizations
I20260105002410 ND Practitioner - Emergency Medicine 3577451012 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Hawkinsville Emergency Medical Services, LLCGroup PAC ID 2769600642, 13 clinicians

Practice addresses (Care Compare)

222 Perry Hwy
Hawkinsville, GA 31036-6748
Phone (229) 200-4950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Physician Services, LLC CurrentSince Mar 31, 2018 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Dec 8, 2025 Accepting new patients
Southland Optim Screven Emergency Medical Services LLC CurrentSince Apr 28, 2023 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Dec 8, 2025 Accepting new patients
Southland Cochran Emergency Medical Services, LLC CurrentSince Jan 1, 2018 Accepting new patients
Weiss Lake Hospitalists, LLC CurrentSince Jun 1, 2019 Accepting new patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Dec 8, 2025 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Dec 8, 2025 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Dec 8, 2025 Accepting new patients
Southland Dodge Emergency Medical Services, LLC CurrentSince Aug 24, 2019 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Apr 4, 2022 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Apr 4, 2022 Accepting new patients
Applecare Memorial Immediate Care Joint Venture LLC CurrentSince Jul 1, 2016 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Dec 8, 2025 Accepting new patients
Nes Georgia, Inc. Past Accepting new patients
Peachtree Immediate Care UC, LLC Past Accepting new patients
Georgia Southern University Family Medicine PastSince Oct 10, 2017 Accepting new patients
Wills Memorial Emergency Medical Services, LLC Past Accepting new patients
Jenkins County Hospital LLC Past Accepting new patients
Nes Georgia, Inc. Past Accepting new patients
Tattnall Emergency Physicians, LLC Past Accepting new patients
Memorial Health Urgentone, Inc. Family Medicine Past Accepting new patients
Screven County Family Health Center, LLC Family Medicine Past Accepting new patients
Northeast Georgia Physicians Group Inc Family Medicine Past Accepting new patients

Locations (25 of 32)

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

1111 Glynco Pkwy
Ste 10
Brunswick, GA 31525
Phone (912) 264-9111

2768 Watson Blvd
#100
Centerville, GA 31028
Phone (478) 302-0001

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

903 Ward St W
Ste A
Douglas, GA 31533
Phone (912) 260-1191

901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

163 S Tallahassee St
Hazlehurst, GA 31539
Phone (912) 375-7781

110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

111 Colonial Way
Jesup, GA 31545
Phone (912) 427-8177

1481 Highway 40 E
Kingsland, GA 31548
Phone (912) 576-6865

275 Perry Pkwy
Ste G
Perry, GA 31069

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

105 Grand Central Blvd
Ste 108
Pooler, GA 31322
Phone (912) 748-1515

107 Canal St
Pooler, GA 31322
Phone (912) 450-1945

247 S Main St
Reidsville, GA 30453
Phone (912) 557-1207

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

14089 Abercorn St
Savannah, GA 31419
Phone (912) 349-4945

1512 Bull St
Unit 6
Savannah, GA 31401
Phone (912) 200-6490

586 Brannen St
Statesboro, GA 30458
Phone (912) 871-6611

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 32

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.

View all 32

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1770670259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 AZALIA DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584908",
            "telephone_number": "912-681-3040",
            "fax_number": "912-681-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CANAL ST",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224016",
            "telephone_number": "912-355-6221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "0404 Forrest Dr",
            "address_2": "Georgia Southern University Health Services",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304600001",
            "country_code": "US",
            "telephone_number": "912-681-0312",
            "fax_number": "912-681-1893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "CATHERINE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "35240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.