Individual provider Active NPI

Matthew Savoy Dickerson, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1902136435
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024172891 Issued in VA
Practice address
1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone
(918) 744-3664
Fax
(918) 748-7688
NPI assigned
Jan 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024172891 VA Primary
Certified Registered Nurse Anesthetist 367500000X 107866 OK
Certified Registered Nurse Anesthetist 367500000X RN612087 PA

Addresses

Primary practice location

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909

Mailing address

1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone (918) 744-3664

Other practice location 1

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

Other practice location 2

1201 Sam Perry Blvd Ste 101
Fredericksburg, VA 22401-4490
Phone (540) 741-7614

Other practice location 3

101 Hospital Center Blvd
Stafford, VA 22554-6200
Phone (540) 741-7614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151028002648 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012042849 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Specialty Services, LLCGroup PAC ID 5991605826, 136 clinicians
American Anesthesiology of Virginia PCGroup PAC ID 6800790023, 514 clinicians
Dogwood Anesthesia Providers LLCGroup PAC ID 2769853084, 141 clinicians
Atlantic Anesthesia, IncGroup PAC ID 4587562152, 177 clinicians
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

1305 Walt Whitman Rd
Suite 300
Melville, NY 11747-4300

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone (804) 520-8272

19455 Deerfield Ave
Suite 204
Leesburg, VA 20176-8102
Phone (703) 724-9950

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 473-0055

8262 Atlee Rd
Mechanicsville, VA 23116-1816
Phone (804) 764-6000

830 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-6000

Hospital & facility affiliations

  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
107866OKMDCertified Registered Nurse Anesthetist
RN612087PAMDCertified Registered Nurse Anesthetist
0024172891VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Virginia LLC Nurse Anesthetist, Certified Registered CurrentSince May 4, 2020 Accepting new patients
SMG Anesthesia Specialists LLC CurrentSince Dec 15, 2025 Accepting new patients
Commonwealth Anesthesia Associates, P.C. CurrentSince Sep 14, 2015 Accepting new patients
Mary Washington Healthcare Specialty Services LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2026 Accepting new patients
Dogwood Anesthesia Providers, LLC CurrentSince Dec 1, 2022 Accepting new patients
Gastrointestinal Specialists LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Feb 6, 2021 Accepting new patients
Surgical Anesthesia Associates, PLLC CurrentSince May 12, 2024 Accepting new patients
Atlantic Anesthesia, Inc CurrentSince Aug 21, 2025 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Feb 6, 2021 Accepting new patients
St. John Anesthesia Services, Inc. Past Accepting new patients

Locations

1201 Sam Perry Blvd
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-4614

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

10800 Midlothian Tpke
Ste 265
North Chesterfield, VA 23235
Phone (804) 594-1383

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

110 N Robinson St
Ste 100
Richmond, VA 23220
Phone (804) 254-5300

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

6602 W Broad St
#B
Richmond, VA 23230
Phone (804) 289-1137

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

134 Business Park Dr
Virginia Beach, VA 23462
Phone (757) 473-0044

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

Organizations & group practices 11

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 6

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": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1902136435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE",
            "address_2": "STE 217",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE",
            "address_2": "STE 217",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-744-3664",
            "fax_number": "918-748-7688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Sam Perry Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014490",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Hospital Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225546200",
            "country_code": "US",
            "telephone_number": "540-741-7614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "MATTHEW",
        "middle_name": "SAVOY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-06",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024172891",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "107866",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN612087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.