Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenton Michael Dickison, PA-C

Individual provider Physician Assistant · NPI 1699364398

Kenton Michael Dickison, PA-C is a Physician Assistant in Dayton, Ohio. Qualified in 2020, 6 years ago. Practices with Premier Health Specialists Inc, a 575-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
6
Licensed in
OH
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4100 W 3rd St
Dayton, OH 45428-9000
Phone: (937) 268-6511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006825RX (OH)

Record details

NPI number1699364398
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 16, 2021
Last updated in NPPESApril 15, 2026
Certification dateApril 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Premier Health Specialists Inc — 575 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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