Individual provider Active NPI

Robert William Dycus, NP-C

  • Family Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1568095453
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903861 Issued in MS
Practice address
1515 Jefferson St
Laurel, MS 39440-4244
Phone
(601) 426-3421
NPI assigned
Feb 19, 2020
Last updated
Jun 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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 903861 MS Primary

Addresses

Primary practice location

1515 Jefferson St
Laurel, MS 39440-4244

Mailing address

1515 Jefferson St
Laurel, MS 39440-4244
Phone (601) 426-3421

Other identifiers 1

IdentifierTypeStateIssuer
09333052MedicaidMS

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
I20201202000262 MS Practitioner - Nurse Practitioner 8628498466 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Health Services,Inc. CurrentSince Nov 30, 2020 Accepting new patients
Outreach Health Services,Inc. CurrentSince Nov 30, 2020 Accepting new patients

Locations

309 N Pine Ave
Heidelberg, MS 39439
Phone (601) 687-1391

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1568095453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404244",
            "telephone_number": "601-426-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404244",
            "telephone_number": "601-426-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCUS",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-19",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09333052",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.