BETH LYNN DICKERSON (NPI# 1700949120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700949120 |
| Entity Type | Individual |
| Full Name | BETH LYNN DICKERSON |
| Credential | NP |
| Practice Address |
111 Omni Drive Seneca SC 29672-9448 |
| Mailing Address |
1 Independence Pt Ste 212 Greenville SC 29615-4536 |
| Practice Telephone | 8648884222 |
| Practice Fax Number | 8648880023 |
| Mailing Telephone | 8647976306 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 300251 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
18068 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP1107 | 05 |
| Street Address |
111 OMNI DRIVE |
| City | SENECA |
| State | SC |
| Zip Code | 29672-9448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700887189 | Jordan Arthur Dean Jr. | Pediatrics | 111 Omni Drive, Seneca, SC 29672-9448 | 2005-08-09 |
| 1174579254 | Antoinette Marie Bannister | Pediatrics | 111 Omni Drive, Seneca, SC 29672-9448 | 2006-05-26 |
| 1598758997 | Lorraine Ann Bruce | Pediatrics | 111 Omni Drive, Seneca, SC 29672-3245 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790308955 | Pooja Kamboj | Student in an Organized Health Care Education/Training Program | 139 Lila Doyle Dr., Seneca, SC 29672 | 2020-05-22 |
| 1578126785 | Johanna Marie Scarino Lemons | Lactation Consultant, Non-RN | 504 Willow Branch Ln, Seneca, SC 29672 | 2019-04-15 |
| 1982067971 | Marthe Melanie Bryant Connah | Family Medicine | 139 Lila Doyle Drive, Family Medicine Residency - Oconee, Seneca, SC 29672 | 2016-03-29 |
| 1558733220 | Alyssa K. Locke | Occupational Therapist | 101 S-37-349, Seneca, SC 29672 | 2015-10-21 |
| 1497857742 | Pulmonary Critical Care & Sleep Associates Pa | Clinic/Center | 107 Omni Drive, Suite A, Seneca, SC 29672 | 2006-09-05 |
| 1659381440 | Timothy Aaron Zeller | Family Medicine | 139 Lila Doyle Dr, Seneca, SC 29672 | 2006-08-08 |
| 1871546978 | Samuel Thomas Drake | Specialist | 103 Omni Dr Ste A, Seneca, SC 29672 | 2006-05-18 |
| 1235123878 | Nancy Matz Thiel | Chiropractor | 355 Katelynn Lane, Seneca, SC 29672 | 2005-09-09 |
| 1265439954 | David E Heape | Emergency Medicine | 298 Memoral Drive, Oconee Memorial Hospital, Seneca, SC 29672 | 2005-07-07 |
| 1407345846 | Prisma Health-upstate | Clinic/Center | 139 Lila Doyle Drive, Seneca, SC 29672 | 2018-05-01 |
| Find all providers in zip 29672 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649254822 | Heide Suzanne Temples | Nurse Practitioner | 457-b Hwy 123 Bypass, Seneca, SC 29678 | 2005-12-01 |
| 1093258527 | Haley Brooke Cannady | Nurse Practitioner | 109 Omni Dr Ste B, Seneca, SC 29672-9448 | 2016-12-01 |
| 1578721247 | Melanie Christine Best | Nurse Practitioner | 3512 State Route 257, Suite 106, Seneca, PA 16346-2946 | 2008-05-29 |
| 1730375031 | Dawn Renee' Russell | Nurse Practitioner | 10706 Clemson Blvd, Seneca, SC 29678-4528 | 2007-09-20 |
| 1154495331 | Susan L Mcgilvra | Nurse Practitioner | 15579 Wells Highway, Seneca, SC 29678-4318 | 2006-11-20 |
| 1124091657 | Joyce Vissage | Nurse Practitioner | 457-b Hwy 123 Bypass, Seneca, SC 29678 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515511 | Naajah Hughes | Nurse Practitioner | 96 Jonathan Lucas Street Csb 428 Msc 608, Charleston, SC 29425-0001 | 2020-07-20 |
| 1558835355 | Conway Hospital Inc | Nurse Practitioner | 124 Professional Park Drive, Ste A, Conway, SC 29526-9260 | 2019-01-15 |
| 1104220433 | Diana L Taylor | Nurse Practitioner | 140 Professional Park Drive, Conway, SC 29526 | 2014-10-15 |
| 1134540008 | Jeanne Egli | Nurse Practitioner | 99 Bridgetown Rd, Goose Creek, SC 29445-5359 | 2013-12-19 |
| 1962839696 | Tracey Christine Wood | Nurse Practitioner | 140 Bandage Ct, Murrells Inlet, SC 29576-5103 | 2013-09-26 |
| 1982037495 | Amanda Mcallister | Nurse Practitioner | 1341 College Park Rd Ste A, Summerville, SC 29486 | 2013-08-20 |
| 1144568650 | Rebecca Pursley Brown | Nurse Practitioner | 128 Camelot Dr, Gaffney, SC 29341-1012 | 2013-01-18 |
| 1891097580 | Jocelyn Miller Snider | Nurse Practitioner | 1223 S Lake Dr, Lexington, SC 29073-6889 | 2010-12-01 |
| 1972805190 | Care House of The Pee Dee Inc | Nurse Practitioner | 1500 Patton Dr, Florence, SC 29501-6520 | 2010-11-19 |
| 1841436219 | Elsie May Hartigan | Nurse Practitioner | 834 W. Meeting St. Suite C, Lancaster, SC 29720 | 2009-01-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.