Kyleen K. Dickerson, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

8043 Issued in NC

Practice address

10010 Falls of Neuse Rd
Raleigh, NC 27614-8494

Phone

(919) 350-1508

Fax

(919) 350-1475

NPI assigned

Aug 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kyleen C. King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437464674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494",
            "telephone_number": "919-350-1508",
            "fax_number": "919-350-1475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Randolph St",
            "address_purpose": "LOCATION",
            "city": "Radford",
            "state": "VA",
            "postal_code": "241412430",
            "country_code": "US",
            "telephone_number": "412-232-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "KYLEEN",
        "middle_name": "K.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC011525",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005582",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEEN",
            "last_name": "KING",
            "middle_name": "C.",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keeshana C Dickens, LCSW-A, LCAS-A
• Keya Dickens
• Mahlon Alan Dickens, MD
• Steven Dickens, D.D.S., M.S.
• Courtney R Dickerson
• Janet R Dickmander, NP
• Diehl Plastic Surgery, PLLC
• Aimee L Diehl, M.A. CCC-SLP
• Cynthia Lyn Diehl, M.D.
• Lee Harold Diehl, M.D.

• Occupational Therapist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.