DICKSON ORTHOPEDICS, PA (NPI# 1033650817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033650817 |
Entity Type | Organization |
Organization Name | DICKSON ORTHOPEDICS, PA |
Other Organization Name | JONESBORO ORTHOPEDICS AND SPORTS MEDICINE |
Practice Address |
1416 E Matthews Suite 200 Jonesboro AR 72401-4632 |
Mailing Address |
1416 E Matthews Ave Suite 200 Jonesboro AR 72401-4362 |
Practice Telephone | 8709321920 |
Enumeration Date | 2017-03-14 |
Last Update Date | 2017-03-14 |
Authorized Official Name | BETTY RODGERS (OFFICE MANAGER) |
Authorized Official Telephone | 8709321820 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PT2017-016 | AR | Physician Assistants & Advanced Practice Nursing Providers |
Other Name | Type Code |
---|---|
Jonesboro Orthopedics and Sports Medicine | Doing Business As Name - Organization |
Street Address |
1416 E MATTHEWS SUITE 200 |
City | JONESBORO |
State | AR |
Zip Code | 72401-4632 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013154483 | Teresa Cleaves | Physician Assistant | 804 River Mist Dr, Jonesboro, GA 30238-5748 | 2009-01-07 |
1174646723 | Karen Dixon | Physician Assistant | 325 Fieldstone Pkwy, Jonesboro, GA 30236-7502 | 2007-04-09 |
1992896880 | Ronald M Jennings | Physician Assistant | 7615 Mount Zion Blvd, Jonesboro, GA 30236-7934 | 2006-09-27 |
1679858112 | M&m Surgical Associates | Physician Assistant | 804 River Mist Dr, Jonesboro, GA 30238-5748 | 2011-10-17 |
1841418225 | Southern Creseant Surgical Assistants | Physician Assistant | 7615 Mount Zion Blvd, Jonesboro, GA 30236-7934 | 2007-04-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912455387 | Anthony D Long Jr. | Physician Assistant | 17 Mockingbird Ln, Pine Bluff, AR 71603-6107 | 2016-09-14 |
1215233887 | Joshua Anthony Trinkle | Physician Assistant | 224 W. Erie Ave, Harrison, AR 72601 | 2011-01-31 |
1831391655 | Mandy Suzanne Mooneyham | Physician Assistant | 3053 N College Ave, Fayetteville, AR 72703-3417 | 2007-06-04 |
1487252755 | David M Street | Physician Assistant | 2010 Active Way, Benton, AR 72022-9267 | 2020-10-09 |
1407460843 | Alexandra Paige Brown | Physician Assistant | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2020-09-02 |
1881158517 | Jordan Lane Milam | Physician Assistant | 5 Saint Vincent Cir Ste 100, Little Rock, AR 72205-5415 | 2019-01-28 |
1790252286 | Allison Henry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-11-01 |
1649755133 | Hillary Michelle Mayberry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-10-01 |
1013417518 | Corey Carver | Physician Assistant | 1000 S 52nd St, Rogers, AR 72758-8610 | 2018-02-20 |
1316485857 | Farrah Jennings | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2017-02-04 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.