Mario S. Dickens, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

690 Issued in TN

Practice address

6116 Shallowford Rd
Ste 118
Chattanooga, TN 37421-7201

Phone

(423) 710-1224

Fax

(423) 710-1228

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Special Care Podiatry of Georgia LLCGroup PAC ID 4880913490, 10 clinicians

Special Care Podiatry of Tennessee, LLCGroup PAC ID 8820398696, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Special Care Podiatry of Tennessee, LLC

  • Podiatrist
  • Chattanooga, TN
  • NPI 1780072371
  Medicare reassignment Care Compare group NPD
• Special Care Podiatry of Georgia, LLC

  • Podiatrist
  • Byron, GA
  • NPI 1891195962
  Medicare reassignment Care Compare group NPD
• Comfort Foot Care LLC

  • Foot & Ankle Surgery Podiatrist
  • Chattanooga, TN
  • NPI 1023252012
  Medicare reassignment Authorized official
• Health Care for Life TN, LLC

  • Optometrist
  • Nashville, TN
  • NPI 1497017586
  Medicare reassignment
• Specialized Podiatry Services P. C.

  • Podiatrist
  • Bloomfield Hills, MI
  • NPI 1184835340
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1902843154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 SHALLOWFORD RD",
            "address_2": "STE 118",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217201",
            "telephone_number": "423-710-1224",
            "fax_number": "423-710-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 SHALLOWFORD RD",
            "address_2": "STE 118",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217201",
            "telephone_number": "423-710-1224",
            "fax_number": "423-710-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "MARIO",
        "middle_name": "S.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4342355",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00744501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512827",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dianne C. Roland, MD
• Madeline Dicenso
• Andrew Dickerson, CRNA
• Patrick Gerard Dickinson, DO
• Mackenzie Mayer Dickson, LCSW
• William Carson Dickson, DO
• Bhumy Dicorato, PHARMD

• Podiatrist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.