Individual provider Active NPI

James A Dickey, O.D.

  • Optometrist
  • Brookville, OH
National Provider Identifier
1508861006
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3342 Issued in OH
Practice address
430 Arlington Rd
Suite B
Brookville, OH 45309-1103
Phone
(937) 770-1265
Fax
(937) 770-1268
NPI assigned
Jun 20, 2005
Last updated
Aug 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1234 NE
Optometrist 152W00000X 3342 OH Primary
Corneal and Contact Management Optometrist 152WC0802X 1234 NE
Corneal and Contact Management Optometrist 152WC0802X 3342 OH

Addresses

Primary practice location

430 Arlington Rd
Suite B
Brookville, OH 45309-1103

Mailing address

1516 Commons Dr
Miamisburg, OH 45342-7805
Phone (308) 430-1305

Other identifiers 1

IdentifierTypeStateIssuer
07163OtherNEBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1234NEMDClinical Social Worker
3342OHMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spex Optical and Foothills Eye Care, PC Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1508861006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 COMMONS DR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427805",
            "telephone_number": "308-430-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ARLINGTON RD",
            "address_2": "SUITE B",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453091103",
            "telephone_number": "937-770-1265",
            "fax_number": "937-770-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1234",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3342",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NE",
            "license": "1234",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "3342",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07163",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.