Sara Marie Dicken, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2842 Issued in TN

Practice address

6650 Eastgate Blvd Ste 104
Lebanon, TN 37090-6018

Phone

(615) 453-9492

Fax

(615) 453-9498

NPI assigned

Oct 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Sara Marie Nyquist Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bee Well Urgent Care LLCGroup PAC ID 0749688133, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Bee Well Urgent Care LLC

  • Family Medicine Physician
  • Lebanon, TN
  • NPI 1134898992
  Medicare reassignment Care Compare group Authorized official
• Genesis Health System

  • Family Medicine Physician
  • Bettendorf, IA
  • NPI 1225018211
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1942297197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 EASTGATE BLVD STE 104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370906018",
            "telephone_number": "615-900-5451",
            "fax_number": "615-900-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 EASTGATE BLVD STE 104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370906018",
            "telephone_number": "615-453-9492",
            "fax_number": "615-453-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEN",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA2842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031810",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "NYQUIST",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Ann De Leo, LCSW
• John William Deason III, PHARMD
• Kayla Lanee Dedman
• Mariah Dent, PHARMD
• Dialysis Clinic Inc.
• Ashley Dillinger
• Jessica Ann Ditto, O.D.
• Doctors Office LLC
• Justin Donnelly, M.S.
• Heather Hancock Dooley, AU.D, CCC-A

• Medical Physician Assistant in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.