Active NPI
Keryn Elizabeth Kwan-Dickinson, LMT
- Specialist
- Coventry, RI
National Provider Identifier
1861626046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT01630
- Practice address
- 137 Sandy Bottom Rd
Coventry, RI 02816-5865 - Phone
- (401) 822-3676
- NPI assigned
- May 4, 2009
- Last updated
- May 4, 2009
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MT01630 | RI | Primary |
Addresses
Primary practice location
137 Sandy Bottom Rd
Coventry, RI 02816-5865
Mailing address
123 Stone Gate Dr
North Kingstown, RI 02852-4745
Phone (603) 568-3817
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT01630 | RI | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Winds Chiropractic, Inc. | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1861626046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 STONE GATE DR",
"city": "NORTH KINGSTOWN",
"state": "RI",
"postal_code": "028524745",
"telephone_number": "603-568-3817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 SANDY BOTTOM RD",
"city": "COVENTRY",
"state": "RI",
"postal_code": "028165865",
"telephone_number": "401-822-3676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN-DICKINSON",
"first_name": "KERYN",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-04",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "RI",
"license": "MT01630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coventry, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.