DR. MAXWELL DICKEY (NPI# 1528488558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528488558 |
| Entity Type | Individual |
| Full Name | DR. MAXWELL DICKEY |
| Credential | M.D. |
| Practice Address |
221 3rd St W Randolph Afb TX 78150-4800 |
| Practice Telephone | 2106524264 |
| Mailing Telephone | 2106524264 |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
28892 | NE | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 28892 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
221 3RD ST W |
| City | RANDOLPH AFB |
| State | TX |
| Zip Code | 78150-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228015 | Garrett R Lyman | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2019-10-30 |
| 1972074102 | Alexander Louis Nestor | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-12-16 |
| 1861973349 | Kimberli M Molina | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-08-23 |
| 1225526668 | Jon Paul Fitzgerald | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-05-01 |
| 1326587494 | Jonathan Madden | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150 | 2017-02-22 |
| 1508308685 | Stephanie Jean Campos | Registered Nurse | 221 3rd St W, Randolph Afb, TX 78150 | 2016-11-07 |
| 1568915643 | Shanna Leah Irizarry-miller | Nurse Practitioner | 221 3rd St W, Randolph Afb, TX 78150 | 2016-07-26 |
| 1215396072 | Kelly L. Riegleman | General Practice | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2016-02-22 |
| 1982086807 | David Brockbank | Dentist | 221 3rd St W, Randolph Afb, TX 78150 | 2015-06-27 |
| 1740619923 | Michael Prater | Pharmacist | 221 3rd St W, Bldg 1040 Rm 1d201, Randolph Afb, TX 78150-4800 | 2013-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1801114905 | Joanna Marliss Funk Nelms | Preventive Medicine | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2010-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295267573 | Quinn Dufurrena | Preventive Medicine | 301 University Blvd # 1110, Galveston, TX 77555-1110 | 2017-03-28 |
| 1760841423 | Anant Shukla | Preventive Medicine | Mendoza Aviation Clinic (11335 Ssg Sims Blvd), El Paso, TX 79935 | 2016-02-23 |
| 1689069296 | Darryl George Demaris | Preventive Medicine | Texas A&m Hsc Com S&w Hospital, 2401 S. 31st Street - Ms-01-w256, Temple, TX 76508-0001 | 2015-03-31 |
| 1639505951 | Mark Richard Hannay | Preventive Medicine | 614 Mccain St Ste 310, Kingsville, TX 78363 | 2013-09-18 |
| 1407198823 | David Chase Rogers | Preventive Medicine | 1100 Wilfod Hall Loop, Bldg. 4556, Lackland Afb, TX 78236-9908 | 2013-03-24 |
| 1326387291 | Skin Institute | Preventive Medicine | 1901 Babcock Rd Ste 200, San Antonio, TX 78229-4545 | 2013-02-12 |
| 1710221742 | Conrad Ivan Dalton | Preventive Medicine | 98 S. Shawnee Ridge Circle, The Woodlands, TX 77382-2555 | 2012-11-15 |
| 1164766358 | Guillermo J. Salazar | Preventive Medicine | 2601 Meacham Blvd, Faa, Asw-300, Fort Worth, TX 76137-4204 | 2012-11-12 |
| 1205139367 | Kenneth Edward Cottle | Preventive Medicine | 148 S Bay Dr, Bullard, TX 75757-8929 | 2010-12-13 |
| 1245498922 | Richard Harris Stoller | Preventive Medicine | 13714 Cape Blf, San Antonio, TX 78216-1605 | 2008-05-29 |
| Find all providers with the same taxonomy | ||||
| City | RANDOLPH AFB |
| Zip Code | 78150 |
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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.