Joseph Kevin Dickenson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19735 Issued in WV

Practice address

2401 S Kanawha St
Suite 104
Beckley, WV 25801-6967

Phone

(304) 894-8211

Fax

(304) 894-8213

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• J Kevin Dickenson MD

  • Surgery Physician
  • Beckley, WV
  • NPI 1043394471
  NPD (past) Authorized official

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1205806353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258020207",
            "telephone_number": "304-894-8211",
            "fax_number": "304-894-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S KANAWHA ST",
            "address_2": "SUITE 104",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016967",
            "telephone_number": "304-894-8211",
            "fax_number": "304-894-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "JOSEPH",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "19735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV LICENSE",
            "identifier": "19735",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7300227000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Dickens
• Kaitlyn Renee Dickens, DSW, MSW, LICSW, ADS
• Peggy Ann Dickens
• Ronald A Dickens, D.D.S.
• Sherril Dickens
• Stacey D Dickenson, M.D.
• Rashida Dickerson
• Tammra Diehl
• Sierra Dillard
• Brooklyn Paige Dillon, CRNA

• Surgery Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.