Active NPI
Jamila Dickerson, ATC
- Athletic Trainer
- Atlanta, GA
National Provider Identifier
1376437079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT004377
- Practice address
- 755 Hank Aaron Dr SW
Atlanta, GA 30315-1120 - Phone
- (470) 351-8460
- NPI assigned
- Jun 6, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT004377 | GA | Primary |
Addresses
Primary practice location
755 Hank Aaron Dr SW
Atlanta, GA 30315-1120
Mailing address
4627 Randalwood CT
Stone Mountain, GA 30083-4348
Phone (470) 351-8460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT004377 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1376437079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4627 RANDALWOOD CT",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300834348",
"telephone_number": "470-351-8460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 HANK AARON DR SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303151120",
"telephone_number": "470-351-8460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "JAMILA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-06",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT004377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.