Active NPI
Ilana F. Dickson, M.D.
- Pediatrics Physician
- Corvallis, OR
National Provider Identifier
1932143344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD24713
- Practice address
- 777 NW 9TH St
Suite 320
Corvallis, OR 97330-6169 - Phone
- (541) 768-4900
- Fax
- (541) 768-4901
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD24713 | OR | Primary |
Addresses
Primary practice location
777 NW 9TH St
Suite 320
Corvallis, OR 97330-6169
Mailing address
777 NW 9TH St
Suite 320
Corvallis, OR 97330-6169
Phone (541) 768-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD24713 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Firstcare Medical Foundation | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1932143344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 NW 9TH ST",
"address_2": "SUITE 320",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973306169",
"telephone_number": "541-768-4900",
"fax_number": "541-768-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 NW 9TH ST",
"address_2": "SUITE 320",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973306169",
"telephone_number": "541-768-4900",
"fax_number": "541-768-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "ILANA",
"middle_name": "F.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD24713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.