NPIMap

Individual provider Active NPI

John D Dickinson, D.O.

  • Neurological Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1457606279
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
O-1102 Issued in ID
Practice address
2353 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 542-4181
Fax
(208) 542-4182
NPI assigned
Jul 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X O-1102 ID Primary

Addresses

Primary practice location

2353 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 542-4181

Other practice location 1

404 N 2nd E
Rexburg, ID 83440-1608
Phone (208) 542-4181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180605002889 ID Practitioner - Neurosurgery 4385933191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

404 N 2ND
Rexburg, ID 83440-1608
Phone (208) 359-1770

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion226
Laminectomy or laminotomy (partial removal of spine bones)55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Nov 30, 2020 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2353 Coronado St
Idaho Falls, ID 83404
Phone (208) 542-4181

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1457606279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2353 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-542-4181",
            "fax_number": "208-542-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-542-4181",
            "fax_number": "208-542-4182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 N 2nd E",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401608",
            "country_code": "US",
            "telephone_number": "208-542-4181",
            "fax_number": "208-542-4182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "O-1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.