DR. TY DICKERSON M.D.
NPI 1639102684
Pediatrics in Salt Lake City, UT
NPI Status: Active since July 09, 2006
Contact Information
100 N MEDICAL DR
PCMC, INPATIENT MEDICINE DIVISION
SALT LAKE CITY, UT
ZIP 84113
Phone: (801) 588-3813
- Individual
- Male
- Pediatrics
- Accepts Insurance
About TY DICKERSON
This page provides the complete NPI Profile along with additional information for Ty Dickerson, a pediatrician established in Salt Lake City, Utah with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1639102684 assigned on July 2006. The practitioner's primary taxonomy code is 208000000X with license number 6279497-1205 (UT). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1639102684
- Provider Name
- DR. TY DICKERSON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 100 N MEDICAL DR PCMC, INPATIENT MEDICINE DIVISION SALT LAKE CITY, UT 84113
- Location Phone
- (801) 588-3813
- Mailing Address
- 1842 S 1100 E SALT LAKE CITY, UT 84105
- Mailing Phone
- (585) 224-5122
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-09-2006
- Last Update Date
- 10-20-2021
- Code Navigator
A pediatrician like Ty Dickerson is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 6279497-1205
- License State
- UT
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 02181735 | MEDICAID (05) | NY |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 3 | 9 | 1 | 0 | 2 | 6 | 8 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 0 | 4 | 6 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 0 + 4 + 6 + 1 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1639102684 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1609820232 | PEDIATRIC GASTROENTEROLOGY DEPARTMENT OF UNIVERSITY OF UTAH Organization | Pediatrics (Pediatric Gastroenterology) | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-3370 |
| 1699729384 | DR. WILLIAM M MCDONNELL Individual | Pediatrics | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-2233 |
| 1972557593 | PEDIATRIC RAPID TREATMENT UNIT DEPARTMENT OF UNIVERSITY OF UTAH Organization | Pediatrics (Pediatric Emergency Medicine) | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 662-1000 |
| 1679528715 | DEPARTMENT OF PEDIATRICS UNIVERSITY OF UTAH Organization | Pediatrics | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-2000 |
| 1295780625 | PEDIATRIC HEMATOLOGY ONCOLOGY-DEPARTMENT OF UNIVERSITY OF UTAH Organization | Pediatrics (Pediatric Hematology-Oncology) | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-2680 |
| 1275570665 | PEDIATRIC EMERGENCY MEDICINE DEPARTMENT OF UNIVERSITY OF UTAH Organization | Pediatrics (Pediatric Emergency Medicine) | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-2233 |
| 1023051166 | UNIVERSITY OF UTAH GENERAL PEDIATRICS Organization | Pediatrics | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-2233 |
| 1821015710 | PAULA J RASMUSSEN AUD Individual | Audiologist | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-3950 |
| 1326069022 | JULIEN T SMITH PHD Individual | Clinical Neuropsychologist | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-3938 |
| 1215944509 | LISA ENA BARNES PT Individual | Physical Therapist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1568479731 | AMBER S PERRY PT Individual | Physical Therapist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1861409047 | JASON RICHARD NORBY AUD Individual | Audiologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1649287731 | SHELLEY NAKASONE MS, CCC-SLP Individual | Speech-Language Pathologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1124035373 | NANCY A MURRAY AUD / SLP Individual | Audiologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1871500975 | SUSAN JILL BECK TIBBITTS SLP Individual | Speech-Language Pathologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1417965799 | PEDIATRIC ANESTHESIOLOGISTS INC Organization | Anesthesiology | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (888) 249-4598 |
| 1245248368 | MARSHA HARDMAN-LUNDELL LCSW Individual | Social Worker (Clinical) | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1114935236 | LORI M FOX SLP Individual | Speech-Language Pathologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1417965518 | BRIAN L THORN PHD Individual | Psychologist | 100 N MEDICAL DR SLC, UT 84113 (801) 588-2000 |
| 1174533046 | MR. KEVIN MERLIN ORGILL RPH Individual | Pharmacist | 100 N MEDICAL DR SALT LAKE CITY, UT 84113 (801) 588-3256 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639102684, enumerated in the NPI registry as an "individual" on July 09, 2006
The provider is located at 100 N Medical Dr Pcmc, Inpatient Medicine Division Salt Lake City, Ut 84113 and the phone number is (801) 588-3813
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Aetna CVS Health, Molina Healthcare, Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on July 09, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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