Roy Dickenson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

55829 Issued in NC

Practice address

524 Signal Hill Drive Ext
Statesville, NC 28625-4391

Phone

(704) 871-1045

NPI assigned

Sep 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1578813630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251894",
            "telephone_number": "704-939-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-871-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "ROY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "55829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Keith Devine, MACC, LCMHC
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• Charles Thomas Dixon, M.S., NCC, LPCA
• Lori M Dixon, RN, MSN, ANP-BC

• All providers in Statesville, NC
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.