MR. KEVIN L DICKERSON C.R.N.A.
NPI 1083786180
Nurse Anesthetist, Certified Registered in Huntington, WV

Q: What is Kevin Dickerson's NPI number?

The NPI number for Kevin Dickerson is 1083786180. It was assigned to this individual provider in the NPPES registry on November 14, 2006.

Q: What is Kevin Dickerson's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Dickerson was last updated on September 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 14, 2006Accepts Medicare Assignment

88.14/100

CMS Quality Rating

2900 1ST AVE, HUNTINGTON, WV 25702(304) 526-1031 Get Directions Write a Review

NPPES record last updated: September 23, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mr. Kevin L Dickerson C.r.n.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEVIN L DICKERSON C.R.N.A. (NPI 1083786180) is an individual nurse anesthetist, certified registered in Huntington, West Virginia, licensed in West Virginia (54468) and active in the NPI registry since November 2006. He is affiliated with St Mary's Medical Center and is a graduate of Other (2006).

NPPES Registry Identity

NPI1083786180

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameMR. KEVIN L DICKERSONCredential: C.R.N.A.

Location Address2900 1ST AVEHuntington, WV 25702-1241

Mailing AddressPo Box 515Barboursville, WV 25504-0515 · (304) 736-6126 · Fax (304) 736-1531

Phone(304) 526-1031

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateNovember 14, 2006

Last NPPES UpdateSeptember 23, 2011

✔ NPI 1083786180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Licenses✔ Licensed in WV · 54468✔ Licensed in OH · 08320

Definition

(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.

2900 1ST AVE, Huntington, WV 25702

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Other Identifiers 5

Other001721151WV · Wv Blue Cross Provider #

Medicare PIN8233961WV

Medicaid3810001843WV

Other550696369-00WV · Wv Workers Comp

Medicare PIN8237301OH

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Kevin L Dickerson C.r.n.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42288052

PECOS Enrollment IDI20040917000825

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Medical Center

Acute Care Hospitals · Huntington, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number510007

Location2900 1st AvenueHuntington, WV 25702 · Cabell County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.14/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.12

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR ALEXANDRA SOWARDS PA-C

Physician Assistant (Medical)