Individual provider Active NPI

Daniel Dickerson, RD

  • Registered Dietitian
  • Quakertown, PA
National Provider Identifier
1972163871
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN006742 Issued in PA
Practice address
708 Juniper St # 2
Quakertown, PA 18951-1510
Phone
(267) 733-7119
Fax
(866) 473-0553
NPI assigned
Jun 13, 2019
Reactivated
Jun 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Registered Dietitian 133V00000X DN006742 PA Primary

Addresses

Primary practice location

708 Juniper St # 2
Quakertown, PA 18951-1510

Mailing address

708 Juniper St # 2
Quakertown, PA 18951-1510
Phone (267) 733-7119

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

State licenses

LicenseStateTypeSpecialty
DN006742PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bucks Weight Management Dietitian, Registered CurrentSince Dec 13, 2022 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

328 W Broad St
Rear
Quakertown, PA 18951
Phone (215) 804-9530

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1972163871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 JUNIPER ST # 2",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189511510",
            "telephone_number": "267-733-7119",
            "fax_number": "866-473-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 JUNIPER ST # 2",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189511510",
            "telephone_number": "267-733-7119",
            "fax_number": "866-473-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "DANIEL",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "deactivation_date": "2019-06-13",
        "reactivation_date": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quakertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.