Individual provider Active NPI

Justin Denhart Dickson, DO

  • Emergency Medicine Physician
  • Wright Patterson Afb, OH
National Provider Identifier
1780119867
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.013591 Issued in OH
Practice address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone
(937) 257-0387
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 011468 AZ
Emergency Medicine Physician 207P00000X 34.013591 OH Primary

Addresses

Primary practice location

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529

Mailing address

9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone (623) 327-4000

Other practice location 1

101 Bodin Cir Fairfield CA 94533
David Grant Medical Center
Fpo, AA 94533
Phone (707) 423-7300

Other practice location 2

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 3

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 4

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 5

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 6

600 W Main St
Troy, OH 45373-3384
Phone (937) 980-7010

Other practice location 7

1 Kettering Way
Piqua, OH 45356-4146
Phone (937) 916-2625

Other practice location 8

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other practice location 9

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 10

450F Washington Jackson Rd
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 11

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211025002425 OH Practitioner - Emergency Medicine 7719233311 Reassigns benefits to 4 organizations
I20250205001895 AZ Practitioner - Emergency Medicine 7719233311 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (954) 939-5000

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
87.11
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
011468AZMDEmergency Medicine Physician
34.013591OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists, Inc Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
PHS Emergency Billing LLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Emergency Professional Services PC Emergency Medicine Current Accepting new patients
Emergency Medicine Physicians of Lancaster, LTD. Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince Jan 17, 2025 Accepting new patients
Innova Emergency Medical Associates PC Emergency Medicine CurrentSince Mar 7, 2025 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

2400 Lakeview Dr
#150
Beavercreek, OH 45431

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

100 Kettering Way
Franklin, OH 45005
Phone (937) 458-4700

8701 Troy Pike
Huber Heights, OH 45424
Phone (937) 558-3309

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

6147 State Route 122
Middletown, OH 45005
Phone (513) 261-3410

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

1 Kettering Way
Piqua, OH 45356
Phone (937) 916-2615

600 W Main St
Troy, OH 45373
Phone (937) 395-6665

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1780119867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-0387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Bodin Cir Fairfield CA 94533",
            "address_2": "David Grant Medical Center",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AA",
            "postal_code": "94533",
            "country_code": "US",
            "telephone_number": "707-423-7300",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453564146",
            "country_code": "US",
            "telephone_number": "937-916-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450F Washington Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "JUSTIN",
        "middle_name": "DENHART",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "011468",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.013591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.