Individual provider Active NPI

James K Dickman, OD

  • Optometrist
  • Coldwater, OH
National Provider Identifier
1063529964
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4640 Issued in OH
Practice address
201 S 2ND St
Coldwater, OH 45828-1747
Phone
(419) 678-3016
Fax
(419) 678-8849
NPI assigned
Aug 24, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4640 OH Primary

Addresses

Primary practice location

201 S 2ND St
Coldwater, OH 45828-1747

Mailing address

PO Box 95
Coldwater, OH 45828-0095
Phone (419) 678-3016

Other identifiers 1

IdentifierTypeStateIssuer
2029889MedicaidOH

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4640OHMDOptometrist

Interoperability endpoints

  • Direct secure messaging: jdickman@professionalfamilyeyecare.eyefinity-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1063529964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "COLDWATER",
            "state": "OH",
            "postal_code": "458280095",
            "telephone_number": "419-678-3016",
            "fax_number": "419-678-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 2ND ST",
            "city": "COLDWATER",
            "state": "OH",
            "postal_code": "458281747",
            "telephone_number": "419-678-3016",
            "fax_number": "419-678-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "JAMES",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029889",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.