Carly Dawn Dickens, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-01862 Issued in KS

Practice address

3651 College Blvd Ste 100B
Leawood, KS 66211-1910

Phone

(913) 362-0031

Fax

(913) 319-7662

NPI assigned

May 7, 2015

Sex

Female

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679951933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD STE 100B",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-362-0031",
            "fax_number": "913-319-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD STE 100B",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-362-0031",
            "fax_number": "913-319-7662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20920 W 151st St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660617247",
            "country_code": "US",
            "telephone_number": "913-782-1148",
            "fax_number": "913-782-1097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "CARLY",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Carle, PH.D., LLC
• Michael J Dempewolf, D.O.
• Dermatology and Skin Cancer Specialists, LLC
• Daniel Destefano, RN
• Elise Marie Dicarlo
• Dickson Diveley Midwest Orthopaedic Clinic LLC
• Dickson Diveley Midwest Orthopaedic Clinic LLC
• Nancy Diehl, PT
• Jeffrey Rhodes Dillow, M.D.
• Dinkel Chiropractic and Acupuncture, PA

• Physician Assistant in Leawood, KS
• Providers in Leawood, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.