Active NPI
James K Dickman, OD
- Optometrist
- Coldwater, OH
National Provider Identifier
1063529964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4640
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2029889 | Medicaid | OH |
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4640 | OH | MD | Optometrist |
Interoperability endpoints
- 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.