Active NPI
Henrietta Dickson, RPH
- Pharmacist
- Avon, IN
National Provider Identifier
1639352099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 050703
- Practice address
- 9500 E US Highway 36
Avon, IN 46123-7366 - Phone
- (317) 209-8204
- NPI assigned
- Dec 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 050703 | NY | Primary |
Addresses
Primary practice location
9500 E US Highway 36
Avon, IN 46123-7366
Mailing address
9500 E US Highway 36
Avon, IN 46123-7366
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050703 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1639352099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 E US HIGHWAY 36",
"city": "AVON",
"state": "IN",
"postal_code": "461237366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 E US HIGHWAY 36",
"city": "AVON",
"state": "IN",
"postal_code": "461237366",
"telephone_number": "317-209-8204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "HENRIETTA",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-08",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "050703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.