Active NPI
Dave Walter Dickinson II
- Hospice Registered Nurse
- Caldwell, ID
National Provider Identifier
1548818586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice Registered Nurse
- License
- 43731
- Practice address
- 18293 Plum Rd
Caldwell, ID 83607-8961 - Phone
- (801) 692-3208
- NPI assigned
- Sep 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice Registered Nurse | 163WH1000X | 43731 | ID | Primary |
Addresses
Primary practice location
18293 Plum Rd
Caldwell, ID 83607-8961
Mailing address
18293 Plum Rd
Caldwell, ID 83607-8961
Phone (801) 692-3208
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43731 | ID | MD | Hospice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1548818586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18293 PLUM RD",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836078961",
"telephone_number": "801-692-3208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18293 PLUM RD",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836078961",
"telephone_number": "801-692-3208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKINSON",
"first_name": "DAVE",
"middle_name": "WALTER",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WH1000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hospice",
"state": "ID",
"license": "43731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.