Catherine K Dickens, M.D.
Individual provider Active NPI Family Medicine Physician · Pooler, GA
NPI 1770670259 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1770670259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35240 (GA)
- Practice address
- 107 Canal St
Pooler, GA 31322-4016 - Phone
- (912) 355-6221
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 32
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- 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, LLC
Practice addresses (Care Compare)
222 Perry Hwy
Hawkinsville, GA 31036-6748
Phone (229) 200-4950
Hospital & facility affiliations
- CHI St Alexius Health Dickinson
- Taylor Regional Hospital
- CHI St Alexius Health Devils Lake
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in GA, AL, ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040308000374 | GA | Practitioner - Family Practice |
3577451012 | Reassigns benefits to 11 organizations |
| I20190326001370 | AL | Practitioner - Hospitalist |
3577451012 | Reassigns benefits to 2 organizations |
| I20260105002410 | ND | Practitioner - Emergency Medicine | 3577451012 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
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
590 Lanier Ave W
Fayetteville, GA 30214
1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776
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 (478) 787-6255
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
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35240 | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00553407E | Medicaid | GA |
Other providers in Pooler, GA
- Wayne Carey Depaz
- Veronika Depinto
- Caitlan Desimas
- Lauren Izetta Dewitt
- Trinity Diaz
- Eva Dittrich
- Divine Keepers Homecare Services LLC
- Tawanda C Dixon
- Beth A Dodds
- Dogwood Pediatric Dentistry of Pooler, LLC
All providers in Pooler, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.