Active NPI
Rebecca Dickerson
- Pharmacist
- Lakeland, FL
National Provider Identifier
1992175350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS54055
- Practice address
- 2300 Griffin Rd
Lakeland, FL 33810-6760 - Phone
- (863) 858-1146
- NPI assigned
- Sep 29, 2015
- Last updated
- Sep 29, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS54055 | FL | Primary |
Addresses
Primary practice location
2300 Griffin Rd
Lakeland, FL 33810-6760
Mailing address
3106 Creekdale CT
Brandon, FL 33511-7316
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 |
|---|---|---|---|
| PS54055 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1992175350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3106 CREEKDALE CT",
"city": "BRANDON",
"state": "FL",
"postal_code": "335117316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 GRIFFIN RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338106760",
"telephone_number": "863-858-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "REBECCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-29",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS54055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.