Individual provider Active NPI

Rachel F Dickerson, FNP

  • Family Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1477909596
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901457 Issued in MS
Practice address
2510 Lakeland Dr
Flowood, MS 39232-9513
Phone
(601) 355-1234
Fax
(601) 326-3566
NPI assigned
May 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 901457 MS Primary

Addresses

Primary practice location

2510 Lakeland Dr
Flowood, MS 39232-9513

Mailing address

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (601) 355-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20161017000317 MS Practitioner - Nurse Practitioner 9133417686 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates, PA CurrentSince Aug 29, 2016 Accepting new patients
Gastrointestinal Associates, P.a. Current Accepting new patients
Gastrointestinal Associates, P.a. CurrentSince Aug 29, 2016 Accepting new patients

Locations

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

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.

NPI Registry JSON

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

{
    "created_epoch": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1477909596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "601-355-1234",
            "fax_number": "601-326-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "RACHEL",
        "middle_name": "F",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-07",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.