Active NPI
Monica Evette Dickenson
- Prosthetic/Orthotic Supplier
- Stafford, VA
National Provider Identifier
1689212078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Practice address
- 2773 Jefferson Davis Hwy Ste 119
Stafford, VA 22554-8324 - Phone
- (703) 672-0680
- NPI assigned
- Dec 16, 2019
- Last updated
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | NU | Primary |
Addresses
Primary practice location
2773 Jefferson Davis Hwy Ste 119
Stafford, VA 22554-8324
Mailing address
25 Cornerstone Dr
Stafford, VA 22554-6208
Phone (703) 626-5803
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monica Dickenson | Prosthetic/Orthotic Supplier | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CSS-Cosmetology Specialty Services
- Durable Medical Equipment & Medical Supplies
- Stafford, VA
- NPI 1033740139
Prosthetic/Orthotic Supplier
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1689212078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CORNERSTONE DR",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225546208",
"telephone_number": "703-626-5803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2773 JEFFERSON DAVIS HWY STE 119",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225548324",
"telephone_number": "703-672-0680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKENSON",
"first_name": "MONICA",
"middle_name": "EVETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-16",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.