NPIMap

Organization Active NPI

Dickson Medical Associates, PC

Doing business as DMA-South

  • Family Medicine Physician
  • Dickson, TN
National Provider Identifier
1972606218
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DICKSON MEDICAL ASSOCIATES, PC
Doing business as
DMA-South
Practice address
758 Highway 46 S
Dickson, TN 37055-2556
Phone
(615) 446-2708
Fax
(615) 446-1359
NPI assigned
Sep 5, 2006
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DICKSON MEDICAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Mrs. Christie Strong
Title
Executive Director
Phone
(615) 441-4477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

758 Highway 46 S
Dickson, TN 37055-2556

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
3158185OtherTNBCBS TN GROUP PIN
CH3856OtherRAILROAD MEDICARE PIN
3721355MedicaidTN

Other names 1

  • DMA-South Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

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
O20240819003036 TN Part A Provider - Rural Health Clinic 3971408774 Practice locations: Dickson, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972606218. Details of each certification follow.

Rural health clinic certification: CCN 888923

Legal name
DICKSON MEDICAL ASSOCIATES, PC
Doing business as
DMA SOUTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 29, 2025
Last certification
Jan 29, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jan 1, 2001 in TN
Enrollment address
758 Highway 46 S
Dickson, TN 37055-2502

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0981192Dickson Medical Associates South758 Highway 46 South, Dickson, TN 37055AccreditationOct 5, 2027

National Provider Directory

National Provider Directory
Part of
Jackson Clinic Rad Dept

Locations

110 Luther Rd
Dickson, TN 37055
Phone (615) 446-5017

110 Mathis Dr
Ste 103
Dickson, TN 37055
Phone (615) 441-4400

110 Mathis Dr
Ste 104
Dickson, TN 37055
Phone (615) 441-4411

113 Highway 70 E
Fl 3
Dickson, TN 37055
Phone (615) 441-4450

114 Highway 70 E
Ste 5
Dickson, TN 37055
Phone (615) 441-1486

127 Crestview Park Dr
Ste 112
Dickson, TN 37055
Phone (615) 441-4533

219 Church St
Dickson, TN 37055
Phone (615) 446-0522

704 E College St
Dickson, TN 37055
Phone (615) 441-4504

758 Highway 46 S
Dickson, TN 37055
Phone (615) 446-2708

4895 E Main St
Erin, TN 37061
Phone (615) 441-4574

2340 Fairview Blvd
Ste 600A
Fairview, TN 37062
Phone (615) 229-3045

111 W Kingston Springs Rd
Kingston Springs, TN 37082
Phone (615) 792-1911

5194 Highway 100
Ste 106
Lyles, TN 37098
Phone (931) 670-1102

5194 Highway 100
Ste 107
Lyles, TN 37098
Phone (615) 441-4503

102 Hillwood Dr
Waverly, TN 37185
Phone (615) 441-4503

2004 Highway 47 N
White Bluff, TN 37187
Phone (615) 797-3646

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kerry W Ross Individual 5% Or Greater Direct Ownership Interest Jul 26, 2004 4.93%
Corporate OfficerVice President Sep 29, 2025 100%
Jeffrey Alan Culp Individual 5% Or Greater Direct Ownership Interest Nov 6, 2023 4.93%
Demond C White Individual 5% Or Greater Direct Ownership Interest Apr 1, 2014 4.93%
Matthew L Sarb Individual 5% Or Greater Direct Ownership Interest Apr 1, 2022 4.93%
Patrick M Luchini Individual 5% Or Greater Direct Ownership Interest Dec 30, 2025 4.93%
Deline Kirubanathan Individual 5% Or Greater Direct Ownership Interest Apr 1, 2022 4.93%
Caroline Farrar Individual 5% Or Greater Direct Ownership Interest Jun 24, 2025 4.93%
Daniel J Sherwood Individual 5% Or Greater Direct Ownership Interest Nov 1, 2020 4.93%
Mary K McNeal Individual 5% Or Greater Direct Ownership Interest Sep 1, 2004 4.93%
Corporate OfficerPresident Sep 29, 2025
Dolores J Lucas Individual 5% Or Greater Direct Ownership Interest Jul 1, 2007 2.4%
David J Blazer Individual 5% Or Greater Direct Ownership Interest Jan 1, 2001 4.43%
Enawgaw B Mehari Individual 5% Or Greater Direct Ownership Interest May 1, 2023 4.93%
Vera H Huffnagle Individual 5% Or Greater Direct Ownership Interest Jan 1, 2001 4.93%
Ehab S Kasasbeh Individual 5% Or Greater Direct Ownership Interest Jul 23, 2014 4.93%
John Bradford McDonough Individual 5% Or Greater Direct Ownership Interest Jul 9, 2025 4.93%
Christie Strong Individual Operational/Managerial ControlExecutive Director May 12, 2018 100%
William Brewer Individual 5% Or Greater Direct Ownership Interest Mar 31, 2021 4.93%
Corporate OfficerTreasurer Jan 1, 2025 100%
Abigail L Ryan Individual 5% Or Greater Direct Ownership Interest Nov 6, 2023 4.93%
David L Ross Individual 5% Or Greater Direct Ownership Interest Aug 1, 2004 4.93%
Robert W Orgain Individual 5% Or Greater Direct Ownership Interest May 29, 1987 4.43%
Mohammad a Alsoub Individual 5% Or Greater Direct Ownership Interest Apr 1, 2022 4.93%
Howard M Hammer Individual 5% Or Greater Direct Ownership Interest Feb 15, 2024 4.93%
Corporate OfficerSecretary Jan 1, 2025 100%

Owners & managing parties with NPI records 21

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 21

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1972606218",
    "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": "758 HIGHWAY 46 S",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552556",
            "telephone_number": "615-446-2708",
            "fax_number": "615-446-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DICKSON MEDICAL ASSOCIATES, PC",
        "enumeration_date": "2006-09-05",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "STRONG",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "615-441-4477",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN GROUP PIN",
            "identifier": "3158185",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CH3856",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721355",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMA-South",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DMA-South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.