Active NPI
Jennifer A Dickerson, M.D.
- Cardiovascular Disease Physician
- Mansfield, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 35.082960
- Practice address
- 335 Glessner Ave
Mansfield, OH 44903-2269 - Phone
- (567) 241-7000
- Fax
- (567) 241-7523
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 35.082960 | OH | Primary |
Addresses
Primary practice location
335 Glessner Ave
Mansfield, OH 44903-2269
Mailing address
5400 Frantz Rd Ste 250
Dublin, OH 43016-6102
Other practice location 1
410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-4967
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2826820 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdickerson162720@direct.ohiohealth.com | OhioHealth Physician Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Wright State University Boonshoft School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 S Grant Ave
Columbus, OH 43215-4701
111 S Grant Ave 3Rd FL
Columbus, OH 43215-4701
Phone (614) 566-9184
1325 Clark St
Cambridge, OH 43725-9614
Phone (740) 630-9708
1335 Clark St
Cambridge, OH 43725-9614
Phone (740) 432-2144
1341 Clark St
Cambridge, OH 43725-9614
Phone (740) 435-2873
199 W Main St
Shelby, OH 44875-1490
335 Glessner Ave
Mansfield, OH 44903-2269
393 E Town St
Columbus, OH 43215-4799
Hospital & facility affiliations
- Ohiohealth Mansfield Hospital
- Ohiohealth Shelby Hospital
- University Hospitals Samaritan Medical Center
- Mercy Health - Willard Hospital
- Grant Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohiohealth Corporation | Current | Accepting new patients | |
| Ohiohealth Corporation | Current | Accepting new patients | |
| Ohiohealth Corporation | Cardiovascular Disease | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
Dept L3652
Columbus, OH 43260
393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108
5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161
335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320
Organizations & group practices 4
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Columbus, OH
- NPI 1265627301
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1407292105
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mansfield, OH
- NPI 1487706016
-
- General Acute Care Hospital
- Mansfield, OH
- NPI 1790837235
-
- Critical Access Hospital
- Willard, OH
- NPI 1790731016
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1255377149
-
- General Acute Care Hospital
- Ashland, OH
- NPI 1902882939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1598887341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 FRANTZ RD STE 250",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430166102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 GLESSNER AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449032269",
"telephone_number": "567-241-7000",
"fax_number": "567-241-7523"
}
],
"practiceLocations": [
{
"address_1": "410 W 10th Ave",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432101240",
"country_code": "US",
"telephone_number": "614-293-4967",
"fax_number": "614-293-5614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DICKERSON",
"first_name": "JENNIFER",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OH",
"license": "35.082960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2826820",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdickerson162720@direct.ohiohealth.com",
"affiliation": "Y",
"affiliationName": "OhioHealth Physician Group",
"address_1": "335 Glessner Ave",
"city": "Mansfield",
"state": "OH",
"country_code": "US",
"postal_code": "449032269",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.