Individual provider Active NPI

Sandra L Dickson

  • Non-emergency Medical Transport (VAN)
  • Lakewood, NJ
National Provider Identifier
1881171619
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
1541071 Issued in NJ
Practice address
1935 Swarthmore Ave
St 204
Lakewood, NJ 08701-4565
Phone
(732) 961-6398
Fax
(732) 961-6399
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 1541071 NJ Primary

Addresses

Primary practice location

1935 Swarthmore Ave
St 204
Lakewood, NJ 08701-4565

Mailing address

1935 Swarthmore Ave
St 204
Lakewood, NJ 08701-4565
Phone (732) 961-6398

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

LicenseStateTypeSpecialty
1541071NJMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1881171619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 SWARTHMORE AVE",
            "address_2": "ST 204",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014565",
            "telephone_number": "732-961-6398",
            "fax_number": "732-961-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 SWARTHMORE AVE",
            "address_2": "ST 204",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014565",
            "telephone_number": "732-961-6398",
            "fax_number": "732-961-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "SANDRA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NJ",
            "license": "1541071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.