David L Dedrick, MD

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

MD19899 Issued in OR

Practice address

2042 NE Williamson CT
St. Charles Sleep Center - Bend
Bend, OR 97701-3760

Phone

(541) 706-6905

Fax

(541) 371-4580

NPI assigned

Jan 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Charles Health System, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Redmond, OR
  • NPI 1427140870
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1831177385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5579",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977085579",
            "telephone_number": "541-706-6905",
            "fax_number": "541-371-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 NE WILLIAMSON CT",
            "address_2": "ST. CHARLES SLEEP CENTER - BEND",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013760",
            "telephone_number": "541-706-6905",
            "fax_number": "541-371-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDRICK",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OR",
            "license": "MD19899",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD19899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287267",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decipher Physio, LLC
• Aerlin Decker, PHARMD
• Mary Elizabeth Decker, MD
• Susan Decker, MD
• Toni Mae Decker, O.D.
• Deep Insight PLLC
• Deep Insight PLLC
• Deeply Rooted Dentistry, LLC
• Jennifer Lynn Defeo, PH.D.
• Marissa Defeo, M.A.

• Sleep Medicine (Internal Medicine) Physician in Bend, OR
• Providers in Bend, OR by specialty
• Sleep Medicine (Internal Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.