Active NPI
James J Dickman II, M. D.
- Family Medicine Physician
- Black River Falls, WI
National Provider Identifier
1902838535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 18148
- Practice address
- N6101 Nichols Rd
Black River Falls, WI 54615-5604 - Phone
- (715) 284-5580
- NPI assigned
- Jul 6, 2006
- Last updated
- Apr 10, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31091400 | Medicaid | WI |
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
| Organization | Specialty | Status | New 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
- 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.
-
- Family Medicine Physician
- Black River Falls, WI
- NPI 1790777621
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.