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JORDAN DANIELLE DICKERSON NP
NPI 1093608515
Nurse Practitioner in Tyler, TX

Active since June 02, 2025PECOS EnrolledAccepts Medicare Assignment
912 S FLEISHEL AVE, TYLER, TX 75701(903) 592-6901 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Danielle Dickerson Np NPPES

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

JORDAN DANIELLE DICKERSON NP (NPI 1093608515) is an individual nurse practitioner in Tyler, Texas, licensed in Texas (1204964) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1093608515
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJORDAN DANIELLE DICKERSONCredential: NP
Location Address912 S FLEISHEL AVETyler, TX 75701-2018
Mailing Address912 S Fleishel AveTyler, TX 75701-2018 · (903) 592-6901
Phone(903) 592-6901
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 2, 2025
Last NPPES UpdateJuly 15, 2025
NPPES CertifiedJuly 15, 2025
✔ NPI 1093608515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in TX · 1204964
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
912 S FLEISHEL AVE, Tyler, TX 75701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Danielle Dickerson Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779099346
PECOS Enrollment IDI20250721003008
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.

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450102
Location800 East DawsonTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Jacksonville Hospital

Acute Care Hospitals · Jacksonville, TX
OwnershipProprietary
CMS Certification Number450194
Location501 S RagsdaleJacksonville, TX 75766 · Cherokee County
Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly

Ut Health East Texas Henderson Hospital

Acute Care Hospitals · Henderson, TX
OwnershipProprietary
CMS Certification Number450475
Location300 Wilson StreetHenderson, TX 75652 · Rusk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

DR. VARALAXMI BHAVANI NANNAKA M.D.
Internal Medicine (Pulmonary Disease)
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
NAOMI SUSAN WALLACE NP
Nurse Practitioner
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
KIMBERLY BROWN FNP
Nurse Practitioner
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
DR. CARLA CECILIA WANG-KOCIK MD
Internal Medicine (Pulmonary Disease)
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
CYNTHIA CHANEY NP
Nurse Practitioner (Family)
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
KETAN PATEL M.D.
Internal Medicine (Pulmonary Disease)
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
RHONDA F MATHIS ACNP
Nurse Practitioner (Acute Care)
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901
SLEEP HEALTH DME LLC
Durable Medical Equipment & Medical Supplies
912 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 592-6901

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 Jordan Dickerson's NPI number?

The NPI number for Jordan Dickerson is 1093608515. It was assigned to this individual provider in the NPPES registry on June 2, 2025.

Where is Jordan Dickerson located?

Jordan Dickerson practices at 912 S Fleishel Ave, Tyler, TX 75701. The listed phone number is (903) 592-6901.

What is Jordan Dickerson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jordan Dickerson enrolled in Medicare?

Yes. Jordan Dickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jordan Dickerson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Jordan Dickerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jordan Dickerson affiliated with any hospitals?

According to CMS data, Jordan Dickerson is affiliated with Ut Health East Texas Tyler Regional Hospital, Christus Mother Frances Hospital, Ut Health East Texas Jacksonville Hospital, Ut Health East Texas Athens Hospital and Ut Health East Texas Henderson Hospital.

When was this NPI record last updated?

The NPPES record for Jordan Dickerson was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.