Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Josiah Jackson Dick, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699366740

Josiah Jackson Dick, PA is a Physician Assistant in Springfield, Oregon. Qualified in 2022, 4 years ago. Practices with Icco LLC, a 133-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1460 G St
Springfield, OR 97477-4112
Phone: (541) 726-3166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA209411 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1699366740
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedFebruary 1, 2021
Last updated in NPPESApril 21, 2023
Certification dateApril 21, 2023
Mailing addressPo Box 3028, San Dimas, CA 91773-7028

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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