Deandra Dominique Dickson

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

281051 Issued in FL

Practice address

9145 13TH Ave
Jacksonville, FL 32208

Phone

(904) 723-9713

NPI assigned

Jan 31, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1003407248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9145 13TH AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32208",
            "telephone_number": "904-723-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9145 13TH AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32208",
            "telephone_number": "904-723-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "DEANDRA",
        "middle_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "281051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Frances Dickey, BS,
• Benjamin Olson Dickey, CAA
• Erika Lyn Dickinson, MD
• Hannah Dickinson
• Manuel Gervasio Ruiz Dicks Jr.
• Dennis Dickson, MD
• Misty Jo Dickson, M.ED
• Rebecca Ann Didi, A.R.N.P.
• Mark Edward Diebel
• Macie Dieckman

• All providers in Jacksonville, FL
• Nurse's Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.