Active NPI
David Allen Dickerson
- Pharmacist
- Mount Sterling, KY
National Provider Identifier
1982207841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 019433
- Practice address
- 1201 Indian Mound Dr
Mount Sterling, KY 40353-1534 - Phone
- (859) 498-4320
- Fax
- (859) 499-0882
- NPI assigned
- Nov 20, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 019433 | KY | Primary |
Addresses
Primary practice location
1201 Indian Mound Dr
Mount Sterling, KY 40353-1534
Mailing address
1201 Indian Mound Dr
Mount Sterling, KY 40353-1534
Phone (859) 498-4320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | KY | PHARMACY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019433 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1982207841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 INDIAN MOUND DR",
"city": "MOUNT STERLING",
"state": "KY",
"postal_code": "403531534",
"telephone_number": "859-498-4320",
"fax_number": "859-499-0882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 INDIAN MOUND DR",
"city": "MOUNT STERLING",
"state": "KY",
"postal_code": "403531534",
"telephone_number": "859-498-4320",
"fax_number": "859-499-0882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "DAVID",
"middle_name": "ALLEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-20",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "019433",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY",
"identifier": "NONE",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Sterling, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.