Organization Active NPI

Dickerson Wellness

  • Primary Care Nurse Practitioner
  • Lexington, SC
National Provider Identifier
1033029749
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
DICKERSON WELLNESS
Practice address
1830 S Lake Dr
Box 84432
Lexington, SC 29073-9760
Phone
(803) 477-4745
Fax
(843) 258-4600
NPI assigned
Sep 8, 2026
Last updated
Sep 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
Mrs. Christina Jocklene Edwards, AGPCNP-CNPI 1013753243
Title
Nurse Practitioner/Owner
Phone
(803) 477-4745

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NU
Primary Care Nurse Practitioner 363LP2300X NU Primary
Women's Health Nurse Practitioner 363LW0102X NU

Addresses

Primary practice location

1830 S Lake Dr
Box 84432
Lexington, SC 29073-9760

Mailing address

1830 S Lake Dr
Box 84432
Lexington, SC 29073-9760
Phone (803) 477-4745

National Provider Directory

National Provider Directory

Locations

1830 S Lake Dr
Unit 84432
Lexington, SC 29073

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1033029749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 S LAKE DR",
            "address_2": "BOX 84432",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739760",
            "telephone_number": "803-477-4745",
            "fax_number": "843-258-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S LAKE DR",
            "address_2": "BOX 84432",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739760",
            "telephone_number": "803-477-4745",
            "fax_number": "843-258-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKERSON WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "JOCKLENE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "803-477-4745",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AGPCNP-C"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.