Individual provider Active NPI

Patrick Dickinson, CRNA

  • Certified Registered Nurse Anesthetist
  • Valparaiso, IN
National Provider Identifier
1124430525
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100643 Issued in IN
Practice address
85 E US Highway 6
Valparaiso, IN 46383-8947
Phone
(219) 983-5743
Fax
(219) 983-5994
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 100643 IN Primary

Addresses

Primary practice location

85 E US Highway 6
Valparaiso, IN 46383-8947

Mailing address

85 E US Highway 6
Valparaiso, IN 46383-8947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122000006 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446474928 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physicians Network PLLCGroup PAC ID 5496029407, 218 clinicians

Practice addresses (Care Compare)

3625 N Hall St
Suite 800
Dallas, TX 75219-5106
Phone (214) 252-3535

Hospital & facility affiliations

  • The Hospital at Westlake Medical Center Hospital, Austin, TX, CCN 670006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
100643INMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
Independent Physicians Network PLLC CurrentSince Jan 3, 2024 Accepting new patients
TC Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 16, 2023 Accepting new patients
Pediatric Dentistry of Keller PLLC PastSince Jul 28, 2019 Accepting new patients

Locations

9312 Brodie Ln
Austin, TX 78748
Phone (512) 904-9240

3107 Oak Creek Dr
Ste 100
Austin, TX 78727
Phone (512) 244-7800

14425 Falcon Head Blvd
#1111
Austin, TX 78738
Phone (512) 900-1006

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

2501 W William Cannon Dr
Ste 301
Austin, TX 78745
Phone (512) 439-7300

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

5858 Westheimer Rd
Ste 82
Houston, TX 77057
Phone (713) 784-6065

1627 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (480) 207-9709

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1124430525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-983-5743",
            "fax_number": "219-983-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "PATRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "100643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.