Individual provider Active NPI

Janice Fisher Dickerson, M.D.

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1043250111
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9601609 Issued in NC
Practice address
7420 Market St
Wilmington, NC 28411-9453
Phone
(910) 686-2525
Fax
(910) 550-3787
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9601609 NC Primary

Addresses

Primary practice location

7420 Market St
Wilmington, NC 28411-9453

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 662-6200

Other practice location 1

5145 College Rd S
Wilmington, NC 28412-2207
Phone (910) 662-6000

Other identifiers 2

IdentifierTypeStateIssuer
1043250111MedicaidNC
8911486MedicaidNC

Other names 1

  • Janice Fisher Dickerson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000719 NC Practitioner - Family Practice 4082703210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1960 S 16TH St
Wilmington, NC 28401-6676
Phone (910) 662-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9601609NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC Family Medicine CurrentSince May 1, 2021 Accepting new patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
New Hanover Medical Group PA Family Medicine Past Accepting new patients

Locations

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

5145 College Rd S
Wilmington, NC 28412
Phone (910) 662-6000

7420 Market St
Wilmington, NC 28411
Phone (910) 662-6200

1960 S 16th St
Wilmington, NC 28401
Phone (910) 343-9991

Interoperability endpoints

  • Direct secure messaging: jdickerson1465689@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1043250111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-662-6200",
            "fax_number": "910-686-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 MARKET ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119453",
            "telephone_number": "910-686-2525",
            "fax_number": "910-550-3787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5145 College Rd S",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284122207",
            "country_code": "US",
            "telephone_number": "910-662-6000",
            "fax_number": "910-550-3787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JANICE",
        "middle_name": "FISHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9601609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043250111",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911486",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "DICKERSON",
            "middle_name": "FISHER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.