Carol Ann Dickerson, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

104716 Issued in MO

Practice address

11661 College Blvd Ste 100
Overland Park, KS 66210-4104

Phone

(816) 276-6450

Fax

(816) 276-6455

NPI assigned

Feb 7, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Geriatric Health Services, Inc.

  • Specialist
  • Kansas City, MO
  • NPI 1558387159
  NPD (past)
• Geriatric Healthcare Services, LLC

  • Specialist
  • Kansas City, MO
  • NPI 1164607107
  NPD (past)
• Midwest Metropolitan Physicians Group LLC

  • Psychiatry Physician
  • Kansas City, MO
  • NPI 1851341440
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1568434173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 STATE LINE RD",
            "address_2": "#100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142025",
            "telephone_number": "816-276-6450",
            "fax_number": "816-276-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104104",
            "telephone_number": "816-276-6450",
            "fax_number": "816-276-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "104716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diagnostic Imaging Centers, P.a.
• Diagnostic Radiology Institute of Kansas City, Inc.
• Dialysis Clinic Inc
• Terri Clinton Dichiser, LCPC
• Molly Dickens, MA, LPC, NCC
• Kameron Micheal Dickerson
• Dickson Diveley Midwest Orthopaedic Clinic LLC
• Amber Joy Dickson, LPC
• Dana Faye Dickson, PA
• Marissa A Dickson, PHARMD

• Gerontology Nurse Practitioner in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Gerontology Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.