KELCIE DICKERSON (NPI# 1992105696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992105696 |
| Entity Type | Individual |
| Full Name | KELCIE DICKERSON |
| Credential | PA |
| Practice Address |
3580 State Highway 414 Lyman WY 82937-0001 |
| Mailing Address |
740 S Woodruff Ave Idaho Falls ID 83401-5285 |
| Practice Telephone | 3077862042 |
| Practice Fax Number | 3077864016 |
| Mailing Telephone | 2085429111 |
| Mailing Fax Number | 2085429114 |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PT607 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3580 STATE HIGHWAY 414 |
| City | LYMAN |
| State | WY |
| Zip Code | 82937-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952729857 | Bridger Valley Urgent Care, LLC | Emergency Medicine | 3580 State Highway 414, Lyman, WY 82937 | 2014-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609417088 | Valley Counseling & Coaching LLC | Social Worker | 109 S. Main St. Suite D, Lyman, WY 82937 | 2019-10-07 |
| 1912462326 | South Lincoln Hospital District | Pharmacy | 2822 Wy 414, Lyman, WY 82937 | 2019-02-11 |
| 1023585775 | Autumn Spann | Behavior Technician | 210 Aspen St, Urie, WY 82937 | 2018-10-31 |
| 1821472903 | Cowboy Cares, Inc. | Home Health | 70 Meadow Street, Lyman, WY 82937 | 2015-07-17 |
| 1124442249 | Auralcare Hearing Centers of America, LLC | Clinic/Center | 106 S Main Street, 1, Lyman, WY 82937 | 2014-02-10 |
| 1760668362 | Jason R. Haycock | Chiropractor | 225 W Owen St., Lyman, WY 82937 | 2008-01-14 |
| 1205977006 | Ashby Wood Tippets | Dentist | 37 Mt. Meadow St., Suite C, Lyman, WY 82937 | 2007-02-12 |
| 1588757041 | Lynn J Clifford | Dentist | 37 Meadow St, #11, Lyman, WY 82937 | 2006-10-02 |
| 1639184096 | Randall Carter Christopherson | Physical Therapist | 109 South Main St., Suite D, Lyman, WY 82937 | 2006-07-31 |
| 1033123989 | The Drug Store Inc. | Pharmacist | 106 S. Main St., Lyman, WY 82937 | 2006-07-28 |
| Find all providers in zip 82937 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364051 | Breiana Pedersen | Physician Assistant | 705 Robbies View Dr, Lander, WY 82520-3951 | 2020-10-25 |
| 1821695339 | Breanna Alisia Young | Physician Assistant | 521 Shoshoni Trl, Glenrock, WY 82637-5217 | 2020-10-07 |
| 1083187199 | Chelsea Eddington | Physician Assistant | 620 Granite Peak Dr Apt 307, Casper, WY 82609-4551 | 2019-01-10 |
| 1174006928 | Robert Walter Carpenter | Physician Assistant | 1208 Hilltop Dr Ste 203, Rock Springs, WY 82901-5859 | 2018-09-07 |
| 1821595224 | Abby Rogers | Physician Assistant | 1331 Prairie Ave Ste 2, Cheyenne, WY 82009-4867 | 2018-04-11 |
| 1467950154 | Kaylun Grandy | Physician Assistant | 1952 Harrison Drive, Evanston, WY 82930-3241 | 2018-01-27 |
| 1336657527 | Lauren Andrews | Physician Assistant | 4140a Laramie St, Cheyenne, WY 82001-1969 | 2018-01-22 |
| 1326591058 | Gale Dahlager Crozier | Physician Assistant | 1 Interloop Rd, Jackson Lake Lodge, Moran, WY 83013 | 2016-07-29 |
| 1255724258 | Jason L Ray | Physician Assistant | 103 W. 3rd St., Marbleton, WY 83113 | 2015-03-15 |
| 1679972798 | Jeffrey Brown | Physician Assistant | 925 Birch St, Glenrock, WY 82637-0786 | 2014-08-14 |
| 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.