MR. KEVIN L DICKERSON C.R.N.A.
NPI 1083786180
Nurse Anesthetist, Certified Registered in Huntington, WV
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
Specialties & Licenses
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Kevin Dickerson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Huntington, WV 25702
- Reassigned Medicare billing, Ohio and West Virginia enrollments
- 52 clinicians in this Medicare group
Arlington, TX 76006
- Reassigned Medicare billing, Indiana enrollment
- 287 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, WVPhysician 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.
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.
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.
HUNTINGTON, WV 25702
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
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.
Where is Kevin Dickerson located?
Kevin Dickerson practices at 2900 1st Ave, Huntington, WV 25702. The listed phone number is (304) 526-1031.
What is Kevin Dickerson's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kevin Dickerson enrolled in Medicare?
Yes. Kevin Dickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kevin Dickerson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Dickerson reassigns Medicare benefits to 2 organizations: River Cities Anesthesia PLLC (Huntington, WV) and Northstar Anesthesia Of Indiana LLC (Arlington, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kevin Dickerson affiliated with any hospitals?
According to CMS data, Kevin Dickerson is affiliated with St Mary's Medical Center.
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 15 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.
# Mr. Kevin L Dickerson, C.R.N.A. · NPI 1083786180
Nurse Anesthetist, Certified Registered physician in Huntington, West Virginia. Individual provider, active in the CMS NPPES registry since November 14, 2006.
## Identity
- **NPI:** 1083786180 (Entity type: Individual)
- **Enumerated:** November 14, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 54468 (West Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 2900 1ST AVE, Huntington, WV 25702-1241
- **Phone:** (304) 526-1031
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): River Cities Anesthesia PLLC (NPI 1699845164, Huntington, WV); Northstar Anesthesia Of Indiana LLC (NPI 1043561541, Arlington, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** September 23, 2011
- **Other identifiers:** Other 001721151 (WV); Medicare PIN 8233961 (WV); Medicaid 3810001843 (WV); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1083786180) · Data from the CMS NPPES public registry.