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MR. TIBLI OLANDRUS DICKSON MANAGER
NPI 1003615030
Nursing Home Administrator in Champlin, MN

Active since March 11, 2025
7400 122ND AVE N, CHAMPLIN, MN 55316(612) 865-6220 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Tibli Olandrus Dickson Manager NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TIBLI OLANDRUS DICKSON MANAGER (NPI 1003615030) is an individual nursing home administrator provider in Champlin, Minnesota and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1003615030
Entity TypeIndividualMale
Primary Taxonomy376G00000X
Provider Legal NameMR. TIBLI OLANDRUS DICKSONCredential: MANAGER
Location Address7400 122ND AVE NChamplin, MN 55316-2127
Mailing Address7400 122nd Ave NChamplin, MN 55316-2127 · (612) 865-6220
Phone(612) 865-6220
Sole ProprietorNo
Enumeration DateMarch 11, 2025
NPPES CertifiedMarch 11, 2025
✔ NPI 1003615030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Home AdministratorNursing Service Related Providers
Taxonomy Code376G00000X
Definition
An individual, often licensed by the state, who is responsible for the management of a nursing home.
7400 122ND AVE N, Champlin, MN 55316
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. PANDORA BAZEN DICKSON
Nurse Practitioner (Family)
7400 122ND AVE N
CHAMPLIN, MN 55316
Hennepin County (763) 458-2415
ZEOR HEALTHCARE LLC
In Home Supportive Care
7400 122ND AVE N
CHAMPLIN, MN 55316
Hennepin County (763) 458-2415

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tibli Dickson's NPI number?

The NPI number for Tibli Dickson is 1003615030. It was assigned to this individual provider in the NPPES registry on March 11, 2025.

Where is Tibli Dickson located?

Tibli Dickson practices at 7400 122nd Ave N, Champlin, MN 55316. The listed phone number is (612) 865-6220.

What is Tibli Dickson's specialty?

The primary specialty registered for this NPI is Nursing Home Administrator with taxonomy code 376G00000X.

When was this NPI record last updated?

The NPPES record for Tibli Dickson was last updated on March 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.