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DR. MICHAEL M DICKERSON M.D.
NPI 1073512059
Emergency Medicine in Parkersburg, WV

Active since July 20, 2005PECOS Enrolled
800 GARFIELD AVE, HEALING CENTER AT CCMH, PARKERSBURG, WV 26101(304) 424-2228(304) 420-7128 Get Directions Write a Review

NPPES record last updated: July 20, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Michael M Dickerson M.d. NPPES

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

DR. MICHAEL M DICKERSON M.D. (NPI 1073512059) is an individual emergency medicine provider in Parkersburg, West Virginia, licensed in North Carolina (200001115) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073512059
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. MICHAEL M DICKERSONCredential: M.D.
Location Address800 GARFIELD AVE, HEALING CENTER AT CCMHParkersburg, WV 26101-5340
Mailing Address1602 Greenmont Hills DrVienna, WV 26105-3292 · (304) 424-2228 · Fax (304) 420-7128
Phone(304) 424-2228
Fax(304) 420-7128
Sole ProprietorYes
Enumeration DateJuly 20, 2005
Last NPPES UpdateJuly 20, 2010
✔ NPI 1073512059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NC · 200001115
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
800 GARFIELD AVE, Parkersburg, WV 26101
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Other Identifiers 6

Medicare UPING41209NC
Other127TYNC · Bcbs Of Nc Group #015ck
Medicare ID-Type Unspecified2281277CNC · Group # 2336501
Medicaid89127TYNC
Medicare PINDI0845395
OtherD0709NC · Medcost #

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael M Dickerson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Michael Dickerson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rosebud Indian Health Service
1,040 mi
General Acute Care Hospital
400 SOLDIER CREEK ROAD
Rosebud, SD 57570
  • Reassigned Medicare billing, Texas enrollment
  • 386 clinicians in this Medicare group
NPI 1194757369 (605) 747-3245
Dhhs Ihs Phoenix
1,709 mi
Clinic/Center
1 MAIN ST
Supai, AZ 86435
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Dhhs Ihs Phoenix Area
  • 210 clinicians in this Medicare group
NPI 1184901829 (928) 448-2641
Irene Benn Medical Center
1,806 mi
Clinic/Center
10 LINCOLN ST
Moapa, NV 89025
  • Reassigned Medicare billing, Texas enrollment
  • 143 clinicians in this Medicare group
NPI 1841535317 (775) 784-5327
Dhhs Ihs Phoenix Area
1,838 mi
Public Health, Federal
1970 PALO VERDE
Havasu Lake, CA 92363
  • Reassigned Medicare billing, Texas enrollment
  • 208 clinicians in this Medicare group
NPI 1396022026 (760) 858-4790

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

JENNIFER BUTLER CRNA
Nurse Anesthetist, Certified Registered
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2111
SARAH RANDOLPH M.S., CCC/SLP
Speech-Language Pathologist
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2645
JUDY A COX CRNA
Nurse Anesthetist, Certified Registered
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2590
JULIE A PETTIT CRNA
Nurse Anesthetist, Certified Registered
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2590
KRISTI BURDETTE
Pharmacist
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2120
ASWATHY MATHEWS MD
Student in an Organized Health Care Education/Training Program
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2777
KRISTINA L SULLIVAN CRNA
Nurse Anesthetist, Certified Registered
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2590
STEPHANIE RAE JAMES DO
Emergency Medicine
800 GARFIELD AVE
PARKERSBURG, WV 26101
Wood County (304) 424-2111

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 Michael Dickerson's NPI number?

The NPI number for Michael Dickerson is 1073512059. It was assigned to this individual provider in the NPPES registry on July 20, 2005.

Where is Michael Dickerson located?

Michael Dickerson practices at 800 Garfield Ave Healing Center At Ccmh, Parkersburg, WV 26101. The listed phone number is (304) 424-2228.

What is Michael Dickerson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Michael Dickerson enrolled in Medicare?

Yes. Michael Dickerson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Michael Dickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Dickerson reassigns Medicare benefits to 4 organizations: Rosebud Indian Health Service (Rosebud, SD), Dhhs Ihs Phoenix (Supai, AZ), Irene Benn Medical Center (Moapa, NV) and Dhhs Ihs Phoenix Area (Havasu Lake, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Dickerson was last updated on July 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.