Active NPI
David Alan Dickey, CRNP
- Adult Health Nurse Practitioner
- Woodbridge, VA
National Provider Identifier
1689724437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 0024131738
- Practice address
- 14139 Potomac Mills Road
Woodbridge, VA 22192-4644 - Phone
- (703) 490-7664
- Fax
- (703) 490-7795
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 0024131738 | VA | Primary |
Addresses
Primary practice location
14139 Potomac Mills Road
Woodbridge, VA 22192-4644
Mailing address
2101 East Jefferson Street
Ppqa Medicare Compliance Unit 6 W Attn Theresa Brooks
Rockville, MD 20853
Phone (301) 816-2414
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1689724437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 EAST JEFFERSON STREET",
"address_2": "PPQA MEDICARE COMPLIANCE UNIT 6 W ATTN THERESA BROOKS",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "20853",
"telephone_number": "301-816-2414",
"fax_number": "301-388-1740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14139 POTOMAC MILLS ROAD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924644",
"telephone_number": "703-490-7664",
"fax_number": "703-490-7795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEY",
"first_name": "DAVID",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "VA",
"license": "0024131738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.