Individual provider Active NPI

Joan Marie Dickey, RN, FNP

  • Family Nurse Practitioner
  • Waxhaw, NC
National Provider Identifier
1366507584
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
104518 Issued in NC
Practice address
6705 Wycliffe Ave.
Jaars Health Services
Waxhaw, NC 28173-0248
Phone
(704) 843-6222
Fax
(704) 843-6450
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104518 NC Primary

Addresses

Primary practice location

6705 Wycliffe Ave.
Jaars Health Services
Waxhaw, NC 28173-0248

Mailing address

6622 Old Settlers Rd
Waxhaw, NC 28173-9116
Phone (704) 843-5033

Other identifiers 1

IdentifierTypeStateIssuer
NC201219OtherNCPRESCRIBERS NUMBER

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
104518NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366507584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 OLD SETTLERS RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281739116",
            "telephone_number": "704-843-5033",
            "fax_number": "704-843-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 WYCLIFFE AVE.",
            "address_2": "JAARS HEALTH SERVICES",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281730248",
            "telephone_number": "704-843-6222",
            "fax_number": "704-843-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "104518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIBERS NUMBER",
            "identifier": "NC201219",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.