James Quinton Dickerson IV, PHARM.D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

13200 Issued in TN

Practice address

801 N Main St
Mt Pleasant, TN 38474-1017

Phone

(931) 379-5000

NPI assigned

Sep 8, 2010

Last updated

Sep 8, 2010By the provider in NPPES

Sex

Male

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)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1811204134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N MAIN ST",
            "city": "MT PLEASANT",
            "state": "TN",
            "postal_code": "384741017",
            "telephone_number": "931-379-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N MAIN ST",
            "city": "MT PLEASANT",
            "state": "TN",
            "postal_code": "384741017",
            "telephone_number": "931-379-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JAMES",
        "middle_name": "QUINTON",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TN",
            "license": "13200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Edward Collins, M.A.
• James C Couch III, M.D.
• Peyton Crowell, DPT
• Delta Recovery Solutions
• Diabetes Management Associates
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic, PLLC
• Trever Hawkins
• Charles Vance Hendrickson, DMD
• Hidden Acres Healthcare, LLC (Mt. Pleasant Health & Rehab Center)

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Mt Pleasant, TN
• Providers in Mt Pleasant, TN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.