NPIMap

Organization Active NPI

Dickson Medical Associates, PC

Doing business as DMA Lyles

  • Family Nurse Practitioner
  • Lyles, TN
National Provider Identifier
1912015108
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DICKSON MEDICAL ASSOCIATES, PC
Doing business as
DMA Lyles
Practice address
5194 Highway 100
Suite 106
Lyles, TN 37098-2821
Phone
(931) 670-1102
Fax
(615) 446-1357
NPI assigned
Aug 28, 2006
Last updated
Sep 20, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DICKSON MEDICAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Miss Cindy A Lighthill
Title
Executive Director
Phone
(615) 441-4477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

5194 Highway 100
Suite 106
Lyles, TN 37098-2821

Mailing address

127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121

Other identifiers 2

IdentifierTypeStateIssuer
3721355MedicaidTN
3158185OtherTNBCBS TN GROUP PIN

Other names 1

  • DMA Lyles Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000828 TN Part B Supplier - Clinic/Group Practice 3971408774 Receives reassigned benefits from 58 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Bluff, TN; Waverly, TN; Hohenwald, TN; Fairview, TN; Dickson, TN; Clarksville, TN

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Jackson Clinic Rad Dept

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1912015108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5194 HIGHWAY 100",
            "address_2": "SUITE 106",
            "city": "LYLES",
            "state": "TN",
            "postal_code": "370982821",
            "telephone_number": "931-670-1102",
            "fax_number": "615-446-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "enumeration_date": "2006-08-28",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "LIGHTHILL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "615-441-4477",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721355",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN GROUP PIN",
            "identifier": "3158185",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMA Lyles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lyles, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.