Spencer Dickerson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

888420 Issued in MS

Practice address

1314 19TH Ave
Meridian, MS 39301-4116

Phone

(601) 703-9687

Fax

(601) 703-9920

NPI assigned

Dec 29, 2015

Last updated

Dec 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Anesthesiology Group, IncGroup PAC ID 1759345192, 23 clinicians

Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Meridian Anesthesiology Group, Inc

  • Anesthesiology Physician
  • Meridian, MS
  • NPI 1639181019

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Medical Foundation, Inc.

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1609820539
  Medicare reassignment Care Compare group
• Kemper Cah, Inc.

  dba Ochsner Stennis Hospital Professional Services

  • Emergency Medicine Physician
  • De Kalb, MS
  • NPI 1346546306

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Laird Hospital, Inc.

  dba Ochsner Laird Hospital Professional Services

  • Emergency Medicine Physician
  • Union, MS
  • NPI 1821046798

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Rush Medical Foundation

  dba Professional Services Division

  • Anesthesiology Physician
  • Meridian, MS
  • NPI 1588625594

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Scott Regional Medical Center, Inc

  dba Ochsner Scott Regional Professional Services

  • Emergency Medicine Physician
  • Morton, MS
  • NPI 1639367188

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Kemper Cah, Inc

  dba Ochsner Health Center-Hwy 39

  • Rural Health Clinic/Center
  • Meridian, MS
  • NPI 1275879314
  NPD
• Kemper, Cah, Inc.

  dba Ochsner Health Center-Marion

  • Rural Health Clinic/Center
  • Marion, MS
  • NPI 1669812962
  NPD
• Laird Hospital, Inc

  dba Ochsner Health Center- Collinsville

  • Rural Health Clinic/Center
  • Collinsville, MS
  • NPI 1073959375
  NPD
• Laird Hospital, Inc.

  dba Ochsner Laird Hospital

  • Critical Access Hospital
  • Union, MS
  • NPI 1518924752
  NPD
• Rush Medical Foundation

  dba Ochsner Health Center-Rush

  • Rural Health Clinic/Center
  • Meridian, MS
  • NPI 1275910663
  NPD
• Rush Medical Foundation

  dba Ochsner Watkins Hospital

  • Critical Access Hospital
  • Quitman, MS
  • NPI 1912079625
  NPD

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

• Rush Medical Foundation

  dba Ochsner Rush Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1770543399
  Care Compare affiliation

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1912362385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025183",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-9687",
            "fax_number": "601-703-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "SPENCER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "888420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasherish Derrick
• Diabetic Warehouse, LLC
• Diagnostic Tissue/Cytology Group, PLLC
• Diagnostic Tissue/Cytology Group, PLLC
• Michelle Gomez Dickerson, PMHNP
• Dean Philip Dickinson, PA
• Sharon Diedrichsen, CNM
• Micah Deon Diener
• Robert E Dilworth, M.D.
• Dimensions Wellness Group, LLC

• Certified Registered Nurse Anesthetist in Meridian, MS
• Providers in Meridian, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.