1. Home
  2. Directory
  3. Missouri
  4. Kirkwood
  5. Internal Medicine
  6. NPI Profile

RACHEL ANNE DICKERSON M.D.
NPI 1174797427
Internal Medicine in Kirkwood, MO

Active since April 17, 2008Opted out of Medicare · through Aug 5, 2028
111 PROSPECT AVE STE 202A, KIRKWOOD, MO 63122(314) 394-2973(785) 414-5373 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 28, 2026, Nov 20, 2024, May 3, 2024 and 3 more (6 updates tracked since 2016).

About Rachel Anne Dickerson M.d. NPPES

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

RACHEL ANNE DICKERSON M.D. (NPI 1174797427) is an individual internal medicine provider in Kirkwood, Missouri, licensed in Missouri (2012012812) and active in the NPI registry since April 2008. She has opted out of Medicare through August 5, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1174797427
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameRACHEL ANNE DICKERSONCredential: M.D.
Location Address111 PROSPECT AVE STE 202AKirkwood, MO 63122-6067
Mailing Address111 Prospect Ave Ste 202aKirkwood, MO 63122-6067 · (314) 394-2973 · Fax (785) 414-5373
Phone(314) 394-2973
Fax(785) 414-5373
Sole ProprietorYes
Enumeration DateApril 17, 2008
Last NPPES UpdateJuly 18, 20226 updates tracked since enumeration
NPPES CertifiedJuly 18, 2022
✔ NPI 1174797427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MO · 2012012812
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License 2012012812 (MO)
111 PROSPECT AVE STE 202A, Kirkwood, MO 63122
Open in Google Maps ↗

Other Identifiers 1

Medicaid1174797427MO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Rachel Anne Dickerson M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 5, 2026 through August 5, 2028.

Opt-Out Effective DateAugust 5, 2026
Opt-Out In Effect ThroughAugust 5, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63122 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
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

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 Rachel Dickerson's NPI number?

The NPI number for Rachel Dickerson is 1174797427. It was assigned to this individual provider in the NPPES registry on April 17, 2008.

Where is Rachel Dickerson located?

Rachel Dickerson practices at 111 Prospect Ave Ste 202A, Kirkwood, MO 63122. The listed phone number is (314) 394-2973.

What is Rachel Dickerson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rachel Dickerson enrolled in Medicare?

No. Rachel Dickerson has opted out of Medicare through August 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Rachel Dickerson was last updated on July 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.