Individual provider Active NPI

James J Dickman II, M. D.

  • Family Medicine Physician
  • Black River Falls, WI
National Provider Identifier
1902838535
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18148 Issued in WI
Practice address
N6101 Nichols Rd
Black River Falls, WI 54615-5604
Phone
(715) 284-5580
NPI assigned
Jul 6, 2006
Last updated
Apr 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18148 WI Primary

Addresses

Primary practice location

N6101 Nichols Rd
Black River Falls, WI 54615-5604

Mailing address

N6101 Nichols Rd
Black River Falls, WI 54615-5604
Phone (715) 284-5580

Other identifiers 1

IdentifierTypeStateIssuer
31091400MedicaidWI

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

Practice roles

OrganizationSpecialtyStatusNew patients
Krohn Clinic LTD. Family Medicine Current Accepting new patients

Locations

610 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-4311

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJBDA

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1902838535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6101 NICHOLS RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155604",
            "telephone_number": "715-284-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6101 NICHOLS RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155604",
            "telephone_number": "715-284-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "JAMES",
        "middle_name": "J",
        "name_suffix": "II",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "18148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31091400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.