Michael Jason Dean, RN ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2000167996 Issued in MO

Practice address

1400 Presidents Landing Dr
O Fallon, MO 63366-8475

Phone

(636) 866-1293

NPI assigned

Mar 10, 2006

Last updated

Nov 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - North State, a service of Dignity Healt

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD (past)
• Hillcrest Baptist Medical Center

  dba Baylor Scott & White Medical Center Hillcrest

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1891882833
  NPD (past)
• Hillcrest Family Health Center

  • Family Medicine Physician
  • Waco, TX
  • NPI 1891796694
  NPD (past)
• John T. Baughman PHD LPC PLLC

  • Mental Health Counselor
  • Waco, TX
  • NPI 1407014293
  NPD (past)
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)
• Sleep and Lung Consultants of Texas, P.a.

  • Specialist
  • Waco, TX
  • NPI 1518902030
  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1831167105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PRESIDENTS LANDING DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633668475",
            "telephone_number": "636-866-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PRESIDENTS LANDING DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633668475",
            "telephone_number": "636-866-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MICHAEL",
        "middle_name": "JASON",
        "credential": "RN ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-74934-022",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2000167996",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2000167996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177840901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200622300A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DDK LC
• DDK, LC
• DDK, LC
• DDK, LC
• DDK, LLC
• David Christopher Declue, D.C.
• Ryan Degeeter, PT
• Delmar Gardens of O'Fallon, LLC (Delmar Gardens of O'Fallon)
• Tara Nicole Demand, RN
• Alexander Dematteis IV, ED.D.

• Adult Health Nurse Practitioner in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.