NPIMap

Individual provider Active NPI

Laura C. Dickerson, MD

  • Medical Oncology Physician
  • Gainesville, FL
National Provider Identifier
1417031238
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME89739 Issued in FL
Practice address
6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308
Phone
(352) 332-3900
Fax
(352) 332-5009
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X ME89739 FL
Medical Oncology Physician 207RX0202X ME89739 FL Primary

Addresses

Primary practice location

6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308

Mailing address

PO Box 102222
Attn: Credential Dept.
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
279426800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070921000192 FL Practitioner - Hematology/Oncology 3375637366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

2848 Ctr Pointe Dr
FL 1
Fort Myers, FL 33916-9521
Phone (239) 561-9622

2890 Ctr Pointe Dr
Fort Myers, FL 33916-9521

495 SW State Rd
Suite 47
Lake City, FL 32025-0453
Phone (386) 401-7066

6420 W Newberry Rd E Wing
1 Florida Cancer Specialists P L
Gainesville, FL 32605-4308
Phone (352) 332-3900

795 SW State Rd
Suite 47
Lake City, FL 32025-0453
Phone (386) 401-7066

8260 Gladiolus Dr
Fort Myers, FL 33908-4156
Phone (239) 437-5755

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME89739FLMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Oct 1, 2010 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Hematology Past Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

1147 NW 64th Ter
Gainesville, FL 32605
Phone (352) 333-5152

6420 W Newberry Rd
Ste 100WING
Gainesville, FL 32605

6420 W Newberry Rd
Ste 100
Gainesville, FL 32605
Phone (352) 332-3900

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1417031238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "address_2": "ATTN: CREDENTIAL DEPT.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 W NEWBERRY RD",
            "address_2": "EAST WING, SUITE 100",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054308",
            "telephone_number": "352-332-3900",
            "fax_number": "352-332-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "LAURA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME89739",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME89739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279426800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.