Individual provider Active NPI

Jenna Rae Dickerson, NP

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1821748997
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC004258 Issued in MD
Practice address
1346 Belmont Ave Ste 602
Salisbury, MD 21804-4589
Phone
(443) 978-7317
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC004258 MD Primary

Addresses

Primary practice location

1346 Belmont Ave Ste 602
Salisbury, MD 21804-4589

Mailing address

1346 Belmont Ave Ste 602
Salisbury, MD 21804-4589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220606002586 MD Practitioner - Nurse Practitioner 0345628269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belmont Family Practice, Inc.Group PAC ID 3678854494, 2 clinicians

Practice addresses (Care Compare)

1346 Belmont Ave
Suite 602
Salisbury, MD 21804-4589
Phone (443) 978-7317

Hospital & facility affiliations

  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
  • Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Belmont Family Practice, Inc. Family CurrentSince Mar 23, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1346 Belmont Ave
Ste 602
Salisbury, MD 21804
Phone (443) 978-7317

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1821748997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 BELMONT AVE STE 602",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 BELMONT AVE STE 602",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044589",
            "telephone_number": "443-978-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JENNA",
        "middle_name": "RAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC004258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.