Kyle J Dickall

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

27200 Issued in TN

Practice address

130 W Ravine Rd
Kingsport, TN 37660-3837

Phone

(423) 224-4000

NPI assigned

Oct 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Anesthesia Group PCGroup PAC ID 6901795830, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Covenant Anesthesia Group, PC

  • Anesthesiology Physician
  • Oak Ridge, TN
  • NPI 1639148117
  Medicare reassignment Care Compare group NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• American Anesthesiology of Tennessee, P.C.

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1245279777

  Nurse Anesthetist, Certified Registered

  NPD

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

• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  Care Compare affiliation

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1609417369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 CHESTERFIELD DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632976",
            "telephone_number": "615-604-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKALL",
        "first_name": "KYLE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "198328",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "27200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saurabh Desai, MD
• Dennis Charles Desimone, D.O.
• William E Devens Jr., MD
• Michael Dew, M.D.
• Stephen E Dexter, M.D.
• Debra D Dickens, RN
• Ernest Dickson, PT
• Heather Jeanette Dickson, PMHNP
• Paul Diers, PA-C
• Daniel Martin Dietrich, D.D.S.

• Certified Registered Nurse Anesthetist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.