Evann Dickerson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36200 Issued in FL

Practice address

401 Johnson LN Ste 101
Venice, FL 34285-6369

Phone

(941) 757-3459

NPI assigned

Sep 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

83.26 of 100Reported as group

Quality

86.58

Improvement activities

40

Cost

68.79

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1346854528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3886 DEBERRY DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 JOHNSON LN STE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342856369",
            "telephone_number": "941-757-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "EVANN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Deza, L.P.N., C.L.C.
• Diane M. Robarts, Dom, PA
• Bethzaida Diaz, P.T.A.
• Leslie Kent Diaz Sr., OD
• Elliot D Dibbs, DDS
• Julie Dickinson, ARNP
• Robert Dienes, MD
• Christine Marie Digangi-Korbel, LCSW
• Mary Dilallo, MA, CCC-SLP
• Linda C Dinardo, CS

• Physical Therapist in Venice, FL
• Providers in Venice, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.