NPIMap

Individual provider Active NPI

Richard Warren Dickson, D.O.

  • Internal Medicine Physician
  • Pinehurst, NC
National Provider Identifier
1326040643
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO 1355 Issued in TN
Practice address
155 Memorial Drive
Pinehurst, NC 28374-8710
Phone
(910) 715-2164
Fax
(910) 715-1247
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO 1355 TN Primary

Addresses

Primary practice location

155 Memorial Drive
Pinehurst, NC 28374-8710

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

Other identifiers 2

IdentifierTypeStateIssuer
5845483MedicaidVA
3306187MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081209000377 TN Practitioner - Family PracticePractitioner - Hospitalist 2860553815 Reassigns benefits to 1 organization
I20180205001852 NC Practitioner - HospitalistPractitioner - Internal Medicine 2860553815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-2164

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO 1355TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. Internal Medicine CurrentSince Mar 29, 2014 Accepting new patients
Wellmont Medical Associates Inc Internal Medicine Current Accepting new patients
FHPG, LLC CurrentSince Jan 1, 2018 Accepting new patients
FHPG, LLC CurrentSince Jan 1, 2018 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 29, 2014 Accepting new patients
FHPG, LLC Current Accepting new patients
Emergency Services, PA Past Accepting new patients

Locations

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

Interoperability endpoints

  • Direct secure messaging: rdickson84023@firsthealth.direct-ci.net

Organizations & group practices 8

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 5

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1326040643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066",
            "fax_number": "423-857-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-2164",
            "fax_number": "910-715-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "RICHARD",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO 1355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5845483",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3306187",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.