Individual provider Active NPI

Emily Dickenson, R.N.

  • Registered Nurse
  • Bristol, VA
National Provider Identifier
1043623424
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001204070 Issued in VA
Practice address
19450 Tulsa Dr
Bristol, VA 24202-3462
Phone
(276) 591-6566
NPI assigned
Jun 3, 2014
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001204070 VA Primary

Addresses

Primary practice location

19450 Tulsa Dr
Bristol, VA 24202-3462

Mailing address

19450 Tulsa Dr
Bristol, VA 24202-3462
Phone (276) 591-6566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001204070VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1043623424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19450 TULSA DR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242023462",
            "telephone_number": "276-591-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 TULSA DR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242023462",
            "telephone_number": "276-591-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "EMILY",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001204070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.