Individual provider Active NPI

Edward J Dyson, DC

  • Internist Chiropractor
  • Sicklerville, NJ
National Provider Identifier
1417997529
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
DC005560L Issued in PA
Practice address
504 Sicklerville Rd
Sicklerville, NJ 08081-2626
Phone
(856) 875-1515
NPI assigned
Jun 7, 2006
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X DC005560L PA Primary

Addresses

Primary practice location

504 Sicklerville Rd
Sicklerville, NJ 08081-2626

Mailing address

504 Sicklerville Rd
Sicklerville, NJ 08081-2626
Phone (856) 875-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150223001718 NJ Practitioner - Chiropractic 1951376383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sicklerville ChiropracticGroup PAC ID 3577739036, 3 clinicians

Practice addresses (Care Compare)

504 Sicklerville Rd
Sicklerville, NJ 08081-2626
Phone (856) 875-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC005560LPAMDInternist Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sicklerville Chiropractic CurrentSince Sep 15, 2018 Accepting new patients
Pma Medical Specialists Past Accepting new patients

Locations

504 Sicklerville Rd
Sicklerville, NJ 08081
Phone (856) 875-1515

Organizations & group practices 2

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1417997529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 SICKLERVILLE RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080812626",
            "telephone_number": "856-875-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SICKLERVILLE RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080812626",
            "telephone_number": "856-875-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYSON",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "PA",
            "license": "DC005560L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.