Active NPI
Tamellia Dickerson
- Phlebotomy Technician
- Longs, SC
National Provider Identifier
1386358190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- E2R5R2E4
- Practice address
- 134 Tomoka TRL
Longs, SC 29568-8678 - Phone
- (843) 990-1125
- NPI assigned
- Jan 6, 2023
- Last updated
- Jan 7, 2023
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | E2R5R2E4 | SC | Primary |
Addresses
Primary practice location
134 Tomoka TRL
Longs, SC 29568-8678
Mailing address
134 Tomoka TRL
Longs, SC 29568-8678
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 |
|---|---|---|---|
| E2R5R2E4 | SC | MD | Phlebotomy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highway Health Services LLC | Phlebotomy | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Phlebotomy Technician
- Longs, SC
- NPI 1083328793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673049600000",
"number": "1386358190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 TOMOKA TRL",
"city": "LONGS",
"state": "SC",
"postal_code": "295688678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 TOMOKA TRL",
"city": "LONGS",
"state": "SC",
"postal_code": "295688678",
"telephone_number": "843-990-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "TAMELLIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-06",
"last_updated": "2023-01-07",
"certification_date": "2023-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "SC",
"license": "E2R5R2E4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longs, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.