Russell S Dickerson, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

J1517 Issued in TX

Practice address

1680 Antilley Rd Ste 250
Abilene, TX 79606-5247

Phone

(325) 698-1100

Fax

(325) 698-1108

NPI assigned

Apr 19, 2007

Last updated

Feb 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

University of Texas Southwestern Medical School at Dallas, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group West Texas, PLLCGroup PAC ID 5597747378, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendrick Medical Center Hospital, Abilene, TX, CCN 450229

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Privia Medical Group West Texas, PLLC

  dba Abilene Diagnostic Clinic, PLLC

  • Specialist
  • Abilene, TX
  • NPI 1346242567
  Medicare reassignment Care Compare group NPD
• Russell S Dickerson MD

  • Neurology Physician
  • Abilene, TX
  • NPI 1740367838
  NPD (past) Authorized official
• Privia Medical Group West Texas, PLLC

  dba Abilene Diagnostic Clinics

  • Podiatrist
  • Abilene, TX
  • NPI 1043725062
  NPD
• Hendrick Provider Network

  dba Hendrick Rural Health Clinic San Saba

  • Rural Health Clinic/Center
  • San Saba, TX
  • NPI 1346044401
  NPD (past)
• Privia Medical Group West Texas, PLLC

  • Pathology Specialist/Technologist
  • Abilene, TX
  • NPI 1760482665
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hendrick Medical Center

  • General Acute Care Hospital
  • Abilene, TX
  • NPI 1528064649
  Care Compare affiliation

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1821215237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ANTILLEY RD STE 250",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065247",
            "telephone_number": "325-698-1100",
            "fax_number": "325-698-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ANTILLEY RD STE 250",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065247",
            "telephone_number": "325-698-1100",
            "fax_number": "325-698-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "RUSSELL",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "J1517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125311405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mattie Devries, RPH
• Tyler Andrew Dews
• Diagnostic Acquisition, LLC (Diagnostic Management Group)
• Diagnostic Management Group LTD
• David Diaz, CRNA
• Robert L Dickey, M.D.
• Brittany Celeste Digby
• Digestive Health Consultants of Abilene, PLLC
• Dignity Health Management Center (Big Country AIDS Resources)
• Jamie Elizabeth Dikes, M.ED., LPC, MT-BC

• Neurology Physician in Abilene, TX
• Providers in Abilene, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.

Verify at the official NPI Registry.