Active NPI
Karen Kenney Dickson, MD
- Psychiatry Physician
- Coon Rapids, MN
National Provider Identifier
1821021924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 31904
- Practice address
- 1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708 - Phone
- (763) 746-9583
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 31904 | MN | Primary |
| Geriatric Psychiatry Physician | 2084P0805X | 31904 | MN |
Addresses
Primary practice location
1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Mailing address
1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone (763) 746-9583
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101741 | Other | MN | U-CARE |
| HP20455 | Other | MN | HEALTH PARTNERS |
| 0804006 | Other | MN | PREFERRED ONE |
| 0T553DI | Other | MN | BCBS OF MN |
| 267588900 | Medicaid | MN |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31904 | MN | MD | Geriatric Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1821021924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 COON RAPIDS BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554334708",
"telephone_number": "763-746-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 COON RAPIDS BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554334708",
"telephone_number": "763-746-9583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "KAREN",
"middle_name": "KENNEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "31904",
"primary": true
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "MN",
"license": "31904",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U-CARE",
"identifier": "101741",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP20455",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "0804006",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "0T553DI",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "267588900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.