Individual provider Active NPI

Anna Lee Dickson, PA

  • Physician Assistant
  • Dalton, GA
National Provider Identifier
1710347976
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7825 Issued in GA
Practice address
1200 Memorial Dr
Dalton, GA 30720-2529
Phone
(706) 272-6000
NPI assigned
Mar 2, 2016
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7825 GA Primary

Addresses

Primary practice location

1200 Memorial Dr
Dalton, GA 30720-2529

Mailing address

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160328000554 GA Practitioner - Physician Assistant 1456658079 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7825GAMDPhysician Assistant

Organizations & group practices 2

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1710347976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-272-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-272-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "ANNA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.