MR. KEVIN DICKERSON (NPI# 1629636998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629636998 |
| Entity Type | Individual |
| Full Name | MR. KEVIN DICKERSON |
| Credential | APRN |
| Practice Address |
200 E Chestnut St Louisville KY 40202-1800 |
| Mailing Address |
3112 Timberlake Ct Jeffersonville IN 47130-7629 |
| Practice Telephone | 5026367111 |
| Mailing Telephone | 8129899650 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 3013376 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083786180 | Kevin L Dickerson | Nurse Anesthetist, Certified Registered | 2900 1st Ave, Huntington, WV 25702-1241 | 2006-11-14 |
| 1053396754 | Kevin M. Dickerson | Pediatrics | 4885 Olentangy River Rd, Suite 2-10, Columbus, OH 43214-1926 | 2005-12-14 |
| Street Address |
200 E CHESTNUT ST |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467456384 | Sanford Todd Reikes | Internal Medicine | 200 E Chestnut St, Louisville, KY 40202-1831 | 2005-06-09 |
| 1245845163 | Morgan Daffin | Psychologist | 200 E Chestnut St, Louisville, KY 40202-1831 | 2020-09-09 |
| 1053934612 | Kayla N Larosa | Psychologist | 200 E Chestnut St, Louisville, KY 40202-1831 | 2020-05-18 |
| 1013548973 | Kentucky Ob Hospitalist Services Inc | Obstetrics & Gynecology | 200 E Chestnut St, Louisville, KY 40202-1831 | 2020-01-30 |
| 1003451774 | Elizabeth Turcotte | Nurse Practitioner | 200 E Chestnut St, Louisville, KY 40202-1831 | 2019-11-16 |
| 1972145332 | Brenn Philip Arbra | Registered Nurse | 200 E Chestnut St, Louisville, KY 40202-1831 | 2019-10-17 |
| 1417599200 | Candice Elaine Bacon | Registered Nurse | 200 E Chestnut St, Louisville, KY 40202-1800 | 2019-10-13 |
| 1518510965 | Katrina Mcneal | Nurse Practitioner | 200 E Chestnut St, Louisville, KY 40202-1800 | 2019-07-24 |
| 1013569102 | Hannah Harris | Physician Assistant | 200 E Chestnut St, Louisville, KY 40202-1831 | 2019-07-10 |
| 1932768710 | Jasmina Keserovic | Nurse Anesthetist, Certified Registered | 200 E Chestnut St, Louisville, KY 40202-1831 | 2019-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528533031 | Katherine Berning | Nurse Anesthetist, Certified Registered | 3022 Eagle Pass, Louisville, KY 40217-1727 | 2018-10-11 |
| 1326559733 | Morgan Ann Baumgartle | Nurse Anesthetist, Certified Registered | Norton Children's Hospital 231 E. Chestnut St, Louisville, KY 40202 | 2017-10-12 |
| 1225385909 | Exacta Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 8809 Linn Station Rd, Louisville, KY 40222-5658 | 2012-08-13 |
| 1740543990 | Tiva Oba, L.L.C. | Nurse Anesthetist, Certified Registered | 4729 Razor Creek Way, Louisville, KY 40299-5533 | 2012-06-22 |
| 1124338579 | Kenneth Eugene Doyon | Nurse Anesthetist, Certified Registered | 601 S Floyd St Ste 407, Louisville, KY 40202-1837 | 2010-10-19 |
| 1508176058 | Jaclyn M Johanboeke | Nurse Anesthetist, Certified Registered | 10207 Springhurst Gardens Cir, Louisville, KY 40241-5194 | 2010-10-18 |
| 1487889143 | Sleep Ez Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 10301 Champion Farms Dr, Louisville, KY 40241-6129 | 2009-05-26 |
| 1700062726 | Jake Chris Chang | Nurse Anesthetist, Certified Registered | 530 S Jackson St Rm C2a03, Louisville, KY 40202-1675 | 2008-01-22 |
| 1205984366 | Stanley Ansel Kristiansen | Nurse Anesthetist, Certified Registered | 1702 Trevilian Way, Louisville, KY 40205-2057 | 2007-01-08 |
| 1841358355 | Michael Dewayne Hart | Nurse Anesthetist, Certified Registered | 16604 Chestnut Glen Pl, Louisville, KY 40245-6121 | 2006-12-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.