Individual provider Active NPI

Joel Joseph Dickson, D.C.

  • Chiropractor
  • Gold River, CA
National Provider Identifier
1013384460
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33379 Issued in CA
Practice address
11294 Coloma Rd
Gold River, CA 95670-4486
Phone
(916) 778-6523
NPI assigned
Sep 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33379 CA Primary

Addresses

Primary practice location

11294 Coloma Rd
Gold River, CA 95670-4486

Mailing address

11294 Coloma Rd Ste H
Gold River, CA 95670-4486
Phone (916) 778-6523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210802001955 CA Practitioner - Chiropractic 9335543172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Dickson Chiropractic Corporation Chiropractor CurrentSince Apr 24, 2021 Accepting new patients

Locations

11294 Coloma Rd
Gold River, CA 95670
Phone (916) 778-6523

11294 Coloma Rd
Ste H
Gold River, CA 95670
Phone (916) 778-6523

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1013384460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11294 COLOMA RD STE H",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704486",
            "telephone_number": "916-778-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11294 COLOMA RD",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704486",
            "telephone_number": "916-778-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "JOEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.