Active NPI
Jaimi Delane Dicken, LNV
- Licensed Vocational Nurse
- Rockwall, TX
National Provider Identifier
1376016360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 205138
- Practice address
- 2100 Garrison Dr
Rockwall, TX 75032-7283 - Phone
- (469) 237-1769
- NPI assigned
- Jan 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 205138 | TX | Primary |
Addresses
Primary practice location
2100 Garrison Dr
Rockwall, TX 75032-7283
Mailing address
1965 Silver Hawk Dr
St Augustine, FL 32092-4734
Phone (469) 237-1769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104374100 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205138 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1376016360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1965 SILVER HAWK DR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320924734",
"telephone_number": "469-237-1769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 GARRISON DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750327283",
"telephone_number": "469-237-1769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEN",
"first_name": "JAIMI",
"middle_name": "DELANE",
"credential": "LNV",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-02",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "205138",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104374100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.