Individual provider Active NPI

James P Dickens, M.D.

  • Adult Medicine Physician
  • Sacramento, CA
National Provider Identifier
1215956776
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A55172 Issued in CA
Practice address
701 Howe Ave
BLDG H-50
Sacramento, CA 95825-4670
Phone
(916) 457-7424
Fax
(916) 457-9212
NPI assigned
Jul 18, 2006
Last updated
Mar 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A55172 CA Primary

Addresses

Primary practice location

701 Howe Ave
BLDG H-50
Sacramento, CA 95825-4670

Mailing address

701 Howe Ave
BLDG H-50
Sacramento, CA 95825-4670
Phone (916) 457-7424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061006000554 CA Practitioner - Family Practice 3779589171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55172CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare of Placerville CurrentSince Aug 1, 2009 Accepting new patients

Locations

1980 Broadway
Placerville, CA 95667
Phone (530) 622-3536

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1215956776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOWE AVE",
            "address_2": "BLDG H-50",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254670",
            "telephone_number": "916-457-7424",
            "fax_number": "916-457-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOWE AVE",
            "address_2": "BLDG H-50",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254670",
            "telephone_number": "916-457-7424",
            "fax_number": "916-457-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A55172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.