Mercedes Dickinson, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2052 Issued in OR

Practice address

1744 E McAndrews Rd Ste J
Medford, OR 97504-5576

Phone

(832) 729-7687

NPI assigned

May 21, 2010

Last updated

Nov 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699142400000",
    "number": "1255650800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 WINDSOR AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048052",
            "telephone_number": "832-729-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 E MCANDREWS RD STE J",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045576",
            "telephone_number": "832-729-7687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048052",
            "country_code": "US",
            "telephone_number": "832-729-7687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "MERCEDES",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2052",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Teresa Diaz, QMHA
• Lauren Diaz
• Charles R Dibb, MD
• Ashley Dicharry, CRM
• David Dickinson, DMD
• Rhiannon M Dickison, DC
• Deanna Dickson
• Bethany Diehl, PT, DPT, GCS
• Douglas Kent Diehl, M.D.
• Kari Rose Diehl

• Clinical Neuropsychologist in Medford, OR
• Providers in Medford, OR by specialty
• Clinical Neuropsychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.