Paul W Dickerson, D.C., LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4412 Issued in 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

Last updated

Mar 8, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc of Phoenix PLLCGroup PAC ID 9335363100, 9 clinicians

Afc of Surprise, PLLCGroup PAC ID 9133522675, 12 clinicians

Afc Physical Medicine of Desert Ridge,PLLCGroup PAC ID 6507016169, 9 clinicians

Afc of East Mesa PLLCGroup PAC ID 1951773290, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Afc of East Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1972256857
  Medicare reassignment Care Compare group NPD
• Afc of Phoenix, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1619392362
  Medicare reassignment Care Compare group NPD
• Afc of Surprise, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Surprise, AZ
  • NPI 1255912721
  Medicare reassignment Care Compare group NPD
• Afc Physical Medicine of Desert Ridge,PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1669731303
  Medicare reassignment Care Compare group NPD
• Afc of Peoria, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Peoria, AZ
  • NPI 1154668044
  Medicare reassignment NPD
• Afc of Tempe PLLC

  • Physical Medicine & Rehabilitation Physician
  • Tempe, AZ
  • NPI 1255879854
  Medicare reassignment NPD
• Afc Physical Medicine of Gilbert, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Gilbert, AZ
  • NPI 1528345881
  Medicare reassignment NPD
• Afc Physical Medicine of Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1659645679
  Medicare reassignment NPD
• Afc Physical Medicine of San Tan Valley, PLLC

  • Physical Medicine & Rehabilitation Physician
  • San Tan Valley, AZ
  • NPI 1457638603
  Medicare reassignment NPD

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1861499485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-316-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20860 N TATUM BLVD STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504282",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14239 W Bell Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853742470",
            "country_code": "US",
            "telephone_number": "623-248-4283",
            "fax_number": "623-440-4255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1277 E Missouri Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850142916",
            "country_code": "US",
            "telephone_number": "602-296-4060",
            "fax_number": "602-296-4146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2919 S Ellsworth Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122165",
            "country_code": "US",
            "telephone_number": "480-564-1185",
            "fax_number": "480-590-4375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2145 E Warner Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843549",
            "country_code": "US",
            "telephone_number": "480-664-9443",
            "fax_number": "480-664-9378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270 E Hunt Hwy Ste A-2",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851434962",
            "country_code": "US",
            "telephone_number": "480-882-2222",
            "fax_number": "480-882-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15256 N 75th Ave Ste 360",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814761",
            "country_code": "US",
            "telephone_number": "623-486-2424",
            "fax_number": "623-486-4324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 E Baseline Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852047290",
            "country_code": "US",
            "telephone_number": "480-345-1980",
            "fax_number": "480-926-1721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 S Lindsay Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-726-2500",
            "fax_number": "480-726-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "D.C., LTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4412",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "AZ",
            "license": "4412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ariana Dicken
• Angela Mae Dickerson
• Bridgae Dickerson
• Chante Dickerson, DO
• Kylie Dickerson, MD
• Rachel Dickert, OD
• Marguerite A Dickey, PHD
• Bridget Maurine Dickinson, RN, CDE
• Doreen Sisk Dickinson, LPC
• Lidia Teresa Dickinson, RPH

• Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.