Individual provider Active NPI

Kenneth Eugene Dickinson III

  • Case Manager/Care Coordinator
  • Pickerington, OH
National Provider Identifier
1215728530
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
10400 Blacklick Eastern Rd
Pickerington, OH 43147-8235
Phone
(614) 726-7359
NPI assigned
May 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

10400 Blacklick Eastern Rd
Pickerington, OH 43147-8235

Mailing address

1494 Wheeler Rd
Zanesville, OH 43701-5159

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

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1215728530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1494 WHEELER RD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437015159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 BLACKLICK EASTERN RD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431478235",
            "telephone_number": "614-726-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.