Thad Shane Dickson, CPHIMS, PMP

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

CPHIMS - 1592 Issued in WA

Practice address

16511 34TH Street KP N
Lakebay, WA 98349-9774

Phone

(253) 651-7482

NPI assigned

Jun 23, 2011

Last updated

May 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Xpio Group Health, LLC

  dba Xpio Health LLC

  • Other Specialist/Technologist
  • Lakebay, WA
  • NPI 1447546809
  Authorized official Same address or phone

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1386930733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511 34TH STREET KP N",
            "city": "LAKEBAY",
            "state": "WA",
            "postal_code": "983499774",
            "telephone_number": "253-651-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 34TH STREET KP N",
            "city": "LAKEBAY",
            "state": "WA",
            "postal_code": "983499774",
            "telephone_number": "253-651-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "THAD",
        "middle_name": "SHANE",
        "credential": "CPHIMS, PMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "WA",
            "license": "CPHIMS - 1592",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMP",
            "identifier": "DICKSTS PMP",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCISSP",
            "identifier": "451268",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPHIMS",
            "identifier": "1592",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Health Care (Community Health Care Pharmacy - Key Medical Center)
• Community Health Care (Key Medical Center)
• Julie Coonan
• Matthew Joel Cozby, D.D.S.
• Ramona Barrett Dickson, LMP
• Olena O Dolzhenko
• Stacie Lynn Flynn, MA, LMHC
• Melissa Linda Fogarty, MA, LMHC
• Jacqueline Marie Furrey, MSW
• Michelle Pearl Gamble, M. ED.

• Other Specialist/Technologist in Lakebay, WA
• Providers in Lakebay, WA by specialty
• Other Specialist/Technologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.