Annette Fluellen Dickerson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007865 Issued in GA

Practice address

2736 Bell Dr SE
Smyrna, GA 30080-2602

Phone

(540) 797-5807

NPI assigned

Sep 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adickerson21371@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Sandy Springs, GA
  • NPI 1144571381
  Medicare reassignment NPD
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment
• NSH Cancer Institute Professional Services G LLC

  • Durable Medical Equipment & Medical Supplies
  • Blue Ridge, GA
  • NPI 1629329792
  NPD
• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1316394976
  NPD (past)
• NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1124379284
  NPD (past)

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

• Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1114113362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 BELL DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 BELL DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802602",
            "telephone_number": "540-797-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "ANNETTE",
        "middle_name": "FLUELLEN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "annette.dickersonpac.d1.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "980 Johnson Ferry Rd Ste 940",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• June Deschamps
• Alyssa Noelle Dewberry, M.ED, CCC-SLP
• Gurdrishti Dhawan, DPM
• Diane Hao Nguyen DDS, P.C.
• Latoya Dickens, PHARM D
• Starr Patrice Dickerson, FNP-BC
• Digicom Healthcare Solution
• Dillon & Greene Dental Services LLC
• Dinwiddie Home Healthcare LLC
• Colin C Dircks, MD

• Physician Assistant in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.