Active NPI
Jessica Leeann Dickerson, A.P.
- Acupuncturist
- Daytona Beach, FL
National Provider Identifier
1912200650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AP 2856
- Practice address
- 820 S Atlantic Ave
Daytona Beach, FL 32118-6404 - Phone
- (386) 243-0440
- NPI assigned
- Dec 20, 2010
- Last updated
- Dec 20, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AP 2856 | FL | Primary |
Addresses
Primary practice location
820 S Atlantic Ave
Daytona Beach, FL 32118-6404
Mailing address
820 S Atlantic Ave
Daytona Beach, FL 32118-6404
Phone (386) 243-0440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP 2856 | FL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292803200000",
"number": "1912200650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S ATLANTIC AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321186404",
"telephone_number": "386-243-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S ATLANTIC AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321186404",
"telephone_number": "386-243-0440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "JESSICA",
"middle_name": "LEEANN",
"credential": "A.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-20",
"last_updated": "2010-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "AP 2856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.