Christy L Dickerson, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN217755 Issued in GA

Practice address

1670 Scott Blvd
Decatur, GA 30033-5637

Phone

(470) 705-7700

NPI assigned

Aug 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Christy L Childs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1508344557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 FRED BISHOP DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147262",
            "telephone_number": "706-333-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 SCOTT BLVD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335637",
            "telephone_number": "470-705-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN217755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "CHILDS",
            "middle_name": "L",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gil A Diaz Vega, M.D.
• Alyse Diaz, RCS
• Nicole R Diaz, CTRS
• Sheena Diaz, LPC
• Holly Joy Dibert I, ATC
• Savannah Diggs, LPC
• Gia M Digiacomo
• Dignity Counseling LLC
• Justine Dillard
• Jennifer Anne Dillon, DMD

• Nurse Practitioner in Decatur, GA
• Providers in Decatur, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.