Individual provider Active NPI

Benjamin Scott Dickerson, D.C.

  • Chiropractor
  • Iowa City, IA
National Provider Identifier
1154732238
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
073221 Issued in IA
Practice address
474 Highway 1 W
Iowa City, IA 52246-4204
Phone
(319) 499-8158
Fax
(319) 483-6627
NPI assigned
May 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 073221 IA Primary

Addresses

Primary practice location

474 Highway 1 W
Iowa City, IA 52246-4204

Mailing address

474 Highway 1 W
Iowa City, IA 52246-4204
Phone (319) 499-8158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140818002703 IA Practitioner - Chiropractic 1153548649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

474 Hwy 1 W
Iowa City, IA 52246-4204
Phone (319) 499-8158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073221IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Chiropractic, LLC Chiropractor CurrentSince Jun 4, 2014 Accepting new patients

Locations

474 Highway 1 W
Iowa City, IA 52246
Phone (319) 499-8158

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1154732238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 HIGHWAY 1 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522464204",
            "telephone_number": "319-499-8158",
            "fax_number": "319-483-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 HIGHWAY 1 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522464204",
            "telephone_number": "319-499-8158",
            "fax_number": "319-483-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "BENJAMIN",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "073221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.