Robert Dickerson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Perry, GA
NPI 1003853052 · NPPES record last updated Feb 17, 2011
Key facts
- NPI
- 1003853052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN129618 (GA)
- Practice address
- 1013 Cherokee Rd
Perry, GA 31069-0824 - Phone
- (478) 318-0414
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 21
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Anesthesia of Montgomery PC
Piedmont Anesthesia LLC
Practice addresses (Care Compare)
2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579
350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 746-7577
Hospital & facility affiliations
- Coliseum Medical Centers, LLC, Dba
- Baptist Medical Center South
- Piedmont Macon North Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in GA, AL, CT, NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040206000765 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5193618650 | Reassigns benefits to 5 organizations |
| I20040503000503 | AL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5193618650 | Reassigns benefits to 1 organization |
| I20120604000137 | CT | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5193618650 | |
| I20130402000020 | NC | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5193618650 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 351 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 36672 | KY | MD | Specialist |
| 3018 | SC | MD | Physician Assistant |
| 4943 | CT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mak Anesthesia Holdings LLC | Current |
Accepting new patients | |
| Sentry Anesthesia Management, LLC | Current |
Accepting new patients | |
| Emory Specialty Associates, LLC | Current |
Accepting new patients | |
| Piedmont Anesthesia LLC | Current |
Accepting new patients | |
| Phoebe Senior Center | Current |
Accepting new patients | |
| Firsthealth of the Carolinas, Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Phoebe Physician Group, Inc | Current |
Accepting new patients | |
| American Anesthesiology of North Carolina, PLLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Firsthealth of the Carolinas, Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic | Current |
Accepting new patients | |
| Henry Anesthesia Associates LLC | Past | Accepting new patients | |
| Greenville Health System | Past | Accepting new patients | |
| Lighthouse Anesthesia LLC | Past | Accepting new patients | |
| Anesthesia Associates of Savannah ,PA | Past | Accepting new patients | |
| South Georgia Regional Anesthesia, PC | Past | Accepting new patients | |
| Alta Anesthesia Associates of Georgia, PC | Nurse Anesthetist, Certified Registered | Past |
Accepting new patients |
| Medical Center Anesthesiology of Athens | Past | Accepting new patients | |
| Eclipse Anesthesia LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Southern Crescent Anesthesiology, PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Associates of Dalton | Past | Accepting new patients |
Locations
417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207
2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802
126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011
151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900
1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
7351 Old Moon Rd
Columbus, GA 31909
Phone (706) 221-2721
2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128
710 Center St
Columbus, GA 31901
Phone (706) 571-1000
100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100
902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100
111 Fairview Park Dr
Dublin, GA 31021
Phone (478) 272-1366
350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367
5730 Glenridge Dr
Ste 400
Sandy Springs, GA 30328
Phone (404) 252-3074
4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100
8 Stephenson Ave
Savannah, GA 31405
Phone (912) 354-2479
1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000
155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000
3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN129618 | GA | Yes |
Addresses
Primary practice location
1013 Cherokee Rd
Perry, GA 31069-0824
Mailing address
PO Box 824
Perry, GA 31069-0824
Phone (478) 318-0414
Other providers in Perry, GA
- Latifah K Decker
- Kaylan Dekle
- Tony Monroe Deloach
- Dermatology Services of Georgia, PLLC
- Shireen Dhir
- Joe Mathis Dixon
- Sue A Dobos
- Julie Cromer Doster
- Dr. Brian Gillis P C
- Dream Team Anesthesia Associates Inc
All providers in Perry, GA · Certified Registered Nurse Anesthetist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.