Paul W Dickerson, D.C., LTD
Individual provider Active NPI Chiropractor · Phoenix, AZ
NPI 1861499485 · NPPES record last updated Mar 8, 2023
Key facts
- NPI
- 1861499485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4412 (AZ)
- Practice address
- 20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282 - Phone
- (480) 563-1144
- Fax
- (480) 563-2371
- NPI assigned
- Jun 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Afc of Phoenix PLLC
Afc of Surprise, PLLC
Afc Physical Medicine of Desert Ridge,PLLC
Afc of East Mesa PLLC
Practice addresses (Care Compare)
1277 E Missouri Ave
Suite 101
Phoenix, AZ 85014-2916
Phone (602) 296-4060
14239 W Bell Rd
Suite 108
Surprise, AZ 85374-2470
Phone (623) 248-4283
20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4282
Phone (480) 563-1144
2919 S Ellsworth Rd
Suite 111
Mesa, AZ 85212-2165
Phone (480) 564-1185
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051103000567 | AZ | Practitioner - Chiropractic | 2365460805 | Reassigns benefits to 9 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afc Physical Medicine of Desert Ridge,PLLC | Current |
Accepting new patients | |
| Afc Physical Medicine of Mesa, PLLC | Current |
Accepting new patients | |
| Afc Physical Medicine of Gilbert, PLLC | Current |
Accepting new patients | |
| Afc of East Mesa, PLLC | Current |
Accepting new patients | |
| Afc Physical Medicine of San Tan Valley, PLLC | Current |
Accepting new patients | |
| Afc of Peoria, PLLC | Current |
Accepting new patients | |
| Afc of Surprise, PLLC | Current |
Accepting new patients | |
| Afc of Tempe PLLC | Current |
Accepting new patients | |
| Afc of Phoenix, PLLC | Current |
Accepting new patients |
Locations
3011 S Lindsay Rd
Ste 101
Gilbert, AZ 85295
Phone (480) 726-2500
1839 S Alma School Rd
Ste 354
Mesa, AZ 85210
2919 S Ellsworth Rd
Ste 111
Mesa, AZ 85212
Phone (480) 564-1185
1839 S Alma School Rd
Mesa, AZ 85210
Phone (708) 612-1170
3130 E Baseline Rd
Ste 107
Mesa, AZ 85204
Phone (480) 345-1980
15256 N 75th Ave
Ste 360
Peoria, AZ 85381
Phone (623) 412-1259
1277 E Missouri Ave
Ste 101
Phoenix, AZ 85014
Phone (602) 296-4060
2 N Central Ave
Ste 120
Phoenix, AZ 85004
Phone (602) 296-4060
20860 N Tatum Blvd
Ste 290
Phoenix, AZ 85050
Phone (480) 563-1144
270 E Hunt Hwy
Ste A2
San Tan Vly, AZ 85143
Phone (480) 882-2222
14239 W Bell Rd
Ste 108
Surprise, AZ 85374
Phone (623) 248-4283
2145 E Warner Rd
Ste 104
Tempe, AZ 85284
Phone (480) 644-9443
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 4412 | AZ | |
| Chiropractor | 111N00000X | 4412 | AZ | Yes |
Addresses
Primary practice location
20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282
Mailing address
1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287
Other practice location 1
14239 W Bell Rd Ste 108
Surprise, AZ 85374-2470
Phone (623) 248-4283
Other practice location 2
1277 E Missouri Ave Ste 101
Phoenix, AZ 85014-2916
Phone (602) 296-4060
Other practice location 3
2919 S Ellsworth Rd Ste 111
Mesa, AZ 85212-2165
Phone (480) 564-1185
Other practice location 4
2145 E Warner Rd Ste 104
Tempe, AZ 85284-3549
Phone (480) 664-9443
Other practice location 5
270 E Hunt Hwy Ste A-2
San Tan Valley, AZ 85143-4962
Phone (480) 882-2222
Other practice location 6
15256 N 75th Ave Ste 360
Peoria, AZ 85381-4761
Phone (623) 486-2424
Other practice location 7
3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290
Phone (480) 345-1980
Other practice location 8
3011 S Lindsay Rd Ste 101
Gilbert, AZ 85295-4333
Phone (480) 726-2500
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.