DR. SUSAN M DIMICK (NPI# 1083663611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083663611 |
| Entity Type | Individual |
| Full Name | DR. SUSAN M DIMICK |
| Credential | M.D. |
| Practice Address |
3317 E Memorial Rd Suite 103 Edmond OK 73013-7105 |
| Mailing Address |
3317 E Memorial Rd Ste 103 Edmond OK 73013-7095 |
| Practice Telephone | 4054750100 |
| Mailing Telephone | 4054750100 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2011-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 15279 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
3317 E MEMORIAL RD SUITE 103 |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-7105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417910266 | Holly Lea Jones | Physical Therapist | 3317 E Memorial Rd, Suite 104, Edmond, OK 73013-7105 | 2006-04-11 |
| 1104163773 | Michael Bruce Etzler | Counselor | 3317 E Memorial Rd, Ste 101, Edmond, OK 73013-7105 | 2013-01-15 |
| 1134143480 | Amy Catherine Reid | Physical Therapist | 3317 E Memorial Rd, Edmond, OK 73013-7095 | 2006-07-27 |
| 1457387102 | Hj Enterprises | Physical Therapist | 3317 E Memorial Rd, Suite 104, Edmond, OK 73013-7095 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1629619473 | Lorie Shannon Shuler | Family Medicine | 1701 Kings Rd, Edmond, OK 73013-4325 | 2019-10-02 |
| 1760030399 | Optimum Primary Care Pllc | Family Medicine | 105 S Bryant Ave Ste 108, Edmond, OK 73034-6330 | 2019-08-27 |
| 1730732116 | Nugenex Health LLC | Family Medicine | 929 Nw 164th St # 342, Edmond, OK 73013-1002 | 2019-07-24 |
| 1265900807 | Zeng Medical Inc | Family Medicine | 1964 Bella Sera Dr, Edmond, OK 73034-2516 | 2018-11-12 |
| 1659855666 | Primary Care Centers of America, LLC | Family Medicine | 800 W 18th St Ste 130, Edmond, OK 73013-3759 | 2018-09-17 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1215399803 | Morfit Medical Pllc | Family Medicine | 2908 Via Esperanza, Edmond, OK 73013-8934 | 2016-03-23 |
| 1134537848 | Medstaffpc | Family Medicine | 28 East Main St, Ste 100, Edmond, OK 73083 | 2014-07-25 |
| 1861806986 | Family Care 323, Pllc | Family Medicine | 1716 Olde North Pl, Edmond, OK 73034-4974 | 2014-06-17 |
| Find all providers in EDMOND | ||||
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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.