Noah Dickens

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5709 Issued in MS

Practice address

433 Main St
Leakesville, MS 39451-6502

Phone

(601) 394-4545

Fax

(601) 394-4546

NPI assigned

Sep 9, 2015

Last updated

Sep 9, 2015By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1861860710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 300",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764",
            "fax_number": "256-350-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 MAIN ST",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394516502",
            "telephone_number": "601-394-4545",
            "fax_number": "601-394-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "NOAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1003819608",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529917620",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Leakesville, MS
• Providers in Leakesville, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.