Individual provider Active NPI

Sandra Adobea Dickson

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1770051526
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN1030200 Issued in DC
Practice address
4 Atlantic St SW
Washington, DC 20032
Phone
(202) 407-7747
NPI assigned
Nov 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R221919 MD
Family Nurse Practitioner 363LF0000X RN1030200 DC Primary

Addresses

Primary practice location

4 Atlantic St SW
Washington, DC 20032

Mailing address

8504 16TH St Apt 503
Silver Spring, MD 20910-5913
Phone (973) 342-6072

Other practice location 1

8504 16th St Apt 503
Silver Spring, MD 20910-5913
Phone (973) 342-6072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20190424000377 DC Practitioner - Nurse Practitioner 1557603511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community of Hope, IncGroup PAC ID 5092612762, 54 clinicians

Practice addresses (Care Compare)

4 Atlantic St SW
Washington, DC 20032-2350
Phone (202) 407-7747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R221919MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community of Hope, Inc CurrentSince Mar 2, 2019 Accepting new patients
Community of Hope Inc. CurrentSince Mar 2, 2019 Accepting new patients
Community of Hope, Inc. Current Accepting new patients

Locations

2155 Champlain St NW
Washington, DC 20009
Phone (202) 407-3080

2120 Bladensburg Rd NE
Washington, DC 20018
Phone (202) 407-3080

4 Atlantic St SW
Washington, DC 20032
Phone (202) 407-3080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1770051526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8504 16TH ST APT 503",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209105913",
            "telephone_number": "973-342-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ATLANTIC ST SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20032",
            "telephone_number": "202-407-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8504 16th St Apt 503",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209105913",
            "country_code": "US",
            "telephone_number": "973-342-6072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "SANDRA",
        "middle_name": "ADOBEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R221919",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1030200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.