NPIMap

Individual provider Active NPI

Reginald Peeler Dickerson, M.D

  • Cardiovascular Disease Physician
  • Gallatin, TN
National Provider Identifier
1942290333
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
43777 Issued in TN
Practice address
300 Steam Plant Rd
Suite 300
Gallatin, TN 37066-3032
Phone
(615) 451-9200
Fax
(615) 989-4217
NPI assigned
Oct 26, 2005
Last updated
Oct 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 43777 TN Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 43777 TN

Addresses

Primary practice location

300 Steam Plant Rd
Suite 300
Gallatin, TN 37066-3032

Mailing address

501 Great Circle Rd
Suite 200
Nashville, TN 37228-1317
Phone (615) 451-9200

Other identifiers 3

IdentifierTypeStateIssuer
1507710MedicaidTN
6011931OtherTNBCBS
P00702357OtherTNRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080924000509 TN Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3678562105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Hahnemann University College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

791 Old Hickory Blvd
Brentwood, TN 37027-4504
Phone (629) 888-5125

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sumner Physician Practices, LLC CurrentSince Dec 1, 2015 Accepting new patients
Saint Thomas Medical Partners Cardiovascular Disease CurrentSince May 13, 2014 Accepting new patients
Sumner Physician Practices LLC CurrentSince Dec 1, 2015 Accepting new patients
Sumner Physician Practices LLC Current Accepting new patients
Health Services of Central Georgia, Inc Cardiovascular Disease PastSince Jun 1, 2004 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Sumner Physician Practices LLC PastSince Dec 1, 2019 Accepting new patients
Sumner Physician Practices LLC Past Accepting new patients

Locations

791 Old Hickory Blvd
Brentwood, TN 37027
Phone (629) 888-5125

225 Big Station Camp Blvd
Gallatin, TN 37066
Phone (615) 328-3380

225 Big Station Camp Blvd
Ste 211
Gallatin, TN 37066
Phone (615) 328-3480

300 Steam Plant Rd
Ste 300
Gallatin, TN 37066
Phone (615) 451-9200

555 Hartsville Pike
Gallatin, TN 37066
Phone (615) 328-5067

300 20th Ave N
Fl 9
Nashville, TN 37203

Interoperability endpoints

  • Direct secure messaging: reginald.dickerson.1@7654.direct.athenahealth.com
  • Direct secure messaging: reginald.dickerson.2@7654.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1942290333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GREAT CIRCLE RD",
            "address_2": "SUITE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281317",
            "telephone_number": "615-451-9200",
            "fax_number": "615-989-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STEAM PLANT RD",
            "address_2": "SUITE 300",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663032",
            "telephone_number": "615-451-9200",
            "fax_number": "615-989-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "REGINALD",
        "middle_name": "PEELER",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "43777",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "43777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507710",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6011931",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00702357",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.