Individual provider Active NPI

Dawn M Bricker, FNP

  • Family Nurse Practitioner
  • Sioux City, IA
National Provider Identifier
1790061612
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
102909 Issued in IA
Practice address
1605 Douglas St
Sioux City, IA 51105-1109
Phone
(712) 234-1005
NPI assigned
Oct 24, 2011
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 102909 IA Primary

Addresses

Primary practice location

1605 Douglas St
Sioux City, IA 51105-1109

Mailing address

1605 Douglas St
Sioux City, IA 51105-1109
Phone (712) 234-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160405001921 NE Practitioner - Nurse Practitioner 9133379431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Physicians and Physical Therapy Clinic PCGroup PAC ID 1951465442, 7 clinicians

Practice addresses (Care Compare)

3900 Dakota Ave
Suite 6
South Sioux City, NE 68776-3696
Phone (402) 494-5173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
102909IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Physicians & Physical Therapy Clinic PC Family CurrentSince Feb 27, 2019 Accepting new patients
Siouxland Adult Medicine, PLLC PastSince Sep 7, 2008 Accepting new patients

Locations

3900 Dakota Ave
Ste 6
South Sioux City, NE 68776
Phone (402) 494-5173

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23894/brand/1/csg/1/fhir/r4

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": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1790061612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 DOUGLAS ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051109",
            "telephone_number": "712-234-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 DOUGLAS ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051109",
            "telephone_number": "712-234-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKER",
        "first_name": "DAWN",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "102909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.