Individual provider Active NPI

Jessica Lea Dickson, APRN

  • Nurse Practitioner
  • Sarasota, FL
National Provider Identifier
1417551995
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11010319 Issued in FL
Practice address
2202 Alpine Ave
Sarasota, FL 34239-4114
Phone
(941) 685-7077
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11010319 FL Primary

Addresses

Primary practice location

2202 Alpine Ave
Sarasota, FL 34239-4114

Mailing address

540 The Rialto
Venice, FL 34285-2900
Phone (941) 486-6927

Other names 1

  • Jessica Lea Voutour Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210204001769 FL Practitioner - Nurse Practitioner 6709290679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accountable Inpatient MedicineGroup PAC ID 5597090274, 51 clinicians

Practice addresses (Care Compare)

8130 Lakewood Main St
Suite 103
Lakewood Ranch, FL 34202-5068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.38 of 100Reported as group
Quality
87.5
Improvement activities
40
Cost
77.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11010319FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Inpatient Medicine CurrentSince May 28, 2022 Accepting new patients

Locations

8130 Lakewood Main St
Ste 103
Lakewood Ranch, FL 34202
Phone (918) 289-7085

8433 Enterprise Cir
Ste 100
Lakewood Ranch, FL 34202
Phone (941) 499-2700

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

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.

Hospital & facility affiliations 1

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": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1417551995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852900",
            "telephone_number": "941-486-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 ALPINE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342394114",
            "telephone_number": "941-685-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "JESSICA",
        "middle_name": "LEA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11010319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VOUTOUR",
            "middle_name": "LEA",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.