J Kevin Dickenson MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19735 Issued in WV

Legal business name

J KEVIN DICKENSON MD

Practice address

2401 S Kanawha St
Suite 104
Beckley, WV 25801-6967

Phone

(304) 894-8211

Fax

(304) 894-8213

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Kevin Dickenson, MDNPI 1205806353

Title

Owner

Phone

(304) 894-8211

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Joseph Kevin Dickenson, MD

  • Surgery Physician
  • Beckley, WV
  • NPI 1205806353
  NPD (past) Authorized official
• Karen K Rainey, PA-C

  • Surgical Physician Assistant
  • Beckley, WV
  • NPI 1699859025
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1043394471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258020207",
            "telephone_number": "304-894-8211",
            "fax_number": "304-894-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S KANAWHA ST",
            "address_2": "SUITE 104",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016967",
            "telephone_number": "304-894-8211",
            "fax_number": "304-894-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KEVIN DICKENSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "DICKENSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-894-8211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WV",
            "license": "19735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS GROUP ID",
            "identifier": "001759805",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elias H Isaac, M.D
• Edna M Jaap
• Charles S Jacinto, PT
• Jackie Withrow Wva Facility Operations LLC
• Daun Leah Jackson, NURSE PRACTITIONER
• Juanima Jackson

• Surgery Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.