Dickson Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA53365 Issued in NJ

Legal business name

DICKSON INC

Doing business as

t/a shiloh medical group

Practice address

851 Main St
Shiloh, NJ 08353-8505

Phone

(856) 455-1464

Fax

(856) 455-6381

NPI assigned

Oct 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert W Dickson, MDNPI 1851314017

Title

Sole Owner

Phone

(856) 455-1464

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• t/a shiloh medical group Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert W Dickson III, MD

  • Internal Medicine Physician
  • Shiloh, NJ
  • NPI 1851314017
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1003904269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110",
            "city": "SHILOH",
            "state": "NJ",
            "postal_code": "083530110",
            "telephone_number": "856-455-1464",
            "fax_number": "856-455-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "city": "SHILOH",
            "state": "NJ",
            "postal_code": "083538505",
            "telephone_number": "856-455-1464",
            "fax_number": "856-455-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "856-455-1464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA53365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2673304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "t/a shiloh medical group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert W Dickson III, MD
• Katherine Hunzer, RD
• Deborah Jeanne Jones, D.C.
• Valerie Blair Probasco, M.A., CCC-SLP

• Internal Medicine Physician in Shiloh, NJ
• Providers in Shiloh, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.

Verify at the official NPI Registry.