Beth Lynn Dickerson, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

18068 Issued in SC

Practice address

450 Old Greenville Hwy
Clemson, SC 29631-1670

Phone

(864) 653-8964

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdickerson128816@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1568799955
  Medicare reassignment NPD
• GHS Partners in Health, Inc.

  • Family Medicine Physician
  • Seneca, SC
  • NPI 1891104295
  NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Easley, SC
  • NPI 1295218642
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1700949120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 OLD GREENVILLE HWY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311670",
            "telephone_number": "864-653-8964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 S Pleasantburg Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296072455",
            "country_code": "US",
            "telephone_number": "864-271-3681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Omni Drive",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296729448",
            "country_code": "US",
            "telephone_number": "864-888-4222",
            "fax_number": "864-888-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "BETH",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "300251",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "18068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1107",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdickerson128816@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Provider",
            "address_1": "890 S Pleasantburg Dr",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296072455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mackenzie Dean
• Donna Deckard-Bullock, ATC, MED
• Abby Taylor Dedecker, ATC
• Eryn Delaney, PH.D
• Jason Matthew Denton, DPT, MS, CSCS
• Sabrina Moniquie Dingle, NP
• Aimee Christina Duffy, M.D.
• William Dukes Jr., MD
• Andrea T Eaton
• Damon Eric Edmond Jr., ATC

• Pediatric Nurse Practitioner in Clemson, SC
• Providers in Clemson, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.