Active NPI
Gerald E Dickson, D.C.
- Chiropractor
- Warren, OH
National Provider Identifier
1003814302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1842
- Practice address
- 8547 E Market St
Warren, OH 44484-2345 - Phone
- (330) 856-6999
- Fax
- (330) 856-2099
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1842 | OH | Primary |
Addresses
Primary practice location
8547 E Market St
Warren, OH 44484-2345
Mailing address
8547 E Market St
Warren, OH 44484-2345
Phone (330) 856-6999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0949488 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120312000806 | OH | Practitioner - Chiropractic | 7012176951 | Practice locations: Warren, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1842 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1003814302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8547 E MARKET ST",
"city": "WARREN",
"state": "OH",
"postal_code": "444842345",
"telephone_number": "330-856-6999",
"fax_number": "330-856-2099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8547 E MARKET ST",
"city": "WARREN",
"state": "OH",
"postal_code": "444842345",
"telephone_number": "330-856-6999",
"fax_number": "330-856-2099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "GERALD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "1842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0949488",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.