Stephanie M Dickson, APRN-CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

11641010-4406 Issued in UT

Practice address

2055 N Main St
Tooele, UT 84074-9819

Phone

(435) 843-3600

NPI assigned

Nov 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Deseret Peak Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Tooele, UT
  • NPI 1518972280

  Single Specialty, UT

  Medicare reassignment NPD
• Mountain West Anesthesia LLC

  • Anesthesiology Physician
  • Lehi, UT
  • NPI 1558391763

  Single Specialty, UT

  Medicare reassignment NPD

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1922765239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WHISPERING WOODS DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749819",
            "telephone_number": "435-843-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Building C 2326 N 400 E Suite 100",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "84074",
            "country_code": "US",
            "telephone_number": "435-843-0180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371155030",
            "country_code": "US",
            "telephone_number": "800-465-3203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "APRN-CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "11641010-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dependable Oxygen Company Inc
• Deseret Peak Anesthesia, LLC
• Desert Sky Mental Health Services
• Melissa Diaz
• Nikayla Dibble, NP
• An Tuong Dinh, MD
• Cameron Dortch, MPAS, PA-C
• John Antoni Douglas, D.O.
• Suzette Dow
• Juliet Dowdle, MFT

• All providers in Tooele, UT
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.