MS. TAMARA DICKERSON DICKERSON AA-C
NPI 1639230428
Anesthesiologist Assistant in Marietta, GA

Q: What is Tamara Dickerson's NPI number?

The NPI number for Tamara Dickerson is 1639230428. It was assigned to this individual provider in the NPPES registry on December 13, 2006. The provider is also known as Mrs. Tamara Dickerson Brackin Aa-C.

Q: What is Tamara Dickerson's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Tamara Dickerson was last updated on July 6, 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.

Active since December 13, 2006

92.93/100

CMS Quality Rating

677 CHURCH ST NE, MARIETTA, GA 30060(770) 794-0477(770) 794-3108 Get Directions Write a Review

NPPES record last updated: July 6, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 6, 2022, Aug 27, 2019 (2 updates tracked since 2019).

On this page

About Ms. Tamara Dickerson Dickerson Aa-c NPPES

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

MS. TAMARA DICKERSON DICKERSON AA-C (NPI 1639230428) is an individual anesthesiologist assistant in Marietta, Georgia, licensed in Georgia (2456) and active in the NPI registry since December 2006. She is affiliated with Wellstar Kennestone Regional Medical Center, maintains 4 additional practice locations, and is a graduate of Emory University School Of Medicine (1993).

NPPES Registry Identity

NPI1639230428

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameMS. TAMARA DICKERSON DICKERSONCredential: AA-C

Location Address677 CHURCH ST NEMarietta, GA 30060-1101

Mailing Address2148 Wyeth WalkMarietta, GA 30062-6047 · (770) 713-4984

Phone(770) 794-0477

Fax(770) 794-3108

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 1993

Enumeration DateDecember 13, 2006

Last NPPES UpdateJuly 6, 20222 updates tracked since enumeration

NPPES CertifiedJuly 6, 2022

✔ NPI 1639230428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in GA · 2456

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

677 CHURCH ST NE, Marietta, GA 30060

Open in Google Maps ↗

Other Names 1

Former Name (1)Mrs. Tamara Dickerson Brackin Aa-c

Secondary Practice Locations 4

Location 1146 Bill Carruth PkwyHiram, GA 30141-3749 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 22540 Windy Hill Rd SEMarietta, GA 30067-8605 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 38954 Hospital DrDouglasville, GA 30134-2272 · Phone (770) 794-0477 · Fax (770) 794-3108

Location 4531 Roselane St NWMarietta, GA 30060-6913 · Phone (770) 794-0477

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Tamara Dickerson Dickerson Aa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860687209

PECOS Enrollment IDI20101111000742

Medicare Billing Reassignments

Medicare enrollment records show Tamara Dickerson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wellstar Medical Group, LLC

Same address

Neurology

677 CHURCH ST NE
Marietta, GA 30060

Reassigned Medicare billing, Georgia enrollment
3,885 clinicians in this Medicare group

NPI 1083027320 (770) 422-2326

Mak Anesthesia Holdings LLC

2.9 mi

Anesthesiology

1300 RIDENOUR BLVD NW STE 300
Kennesaw, GA 30152

Reassigned Medicare billing, Georgia enrollment
629 clinicians in this Medicare group

NPI 1912452939 (770) 702-1806

Georgia Anesthesiologists, PC

9.3 mi

Anesthesiology

1505 STONEBRIDGE PKWY, SUITE 200
Woodstock, GA 30189

Reassigned Medicare billing, Georgia enrollment
Medicare enrollment name: Georgia Anesthesiologists, P.C.
131 clinicians in this Medicare group

NPI 1740299197 (470) 505-8070

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

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.

JILLIAN MARIE BLALOCK DO

Emergency Medicine

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

JAMIN GRAHAM MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

SAUMYA S GURBANI MD, PHD

Radiology (Diagnostic Radiology)

677 CHURCH ST NE, ATTN: GME
MARIETTA, GA 30060

Cobb County (770) 793-7742

JULIA PATRICIA KENDRICK

Registered Nurse

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

DR. HALEY PUCKETT LAWHORN MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

MRS. RHONDA KIM LEE NP-C

Registered Nurse (Wound Care)

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-7173

DEVIN HORTON CRNA

Nurse Anesthetist, Certified Registered

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 794-0477

BRITNEY ELIZABETH BECKETT

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

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 Tamara Dickerson's NPI number?

The NPI number for Tamara Dickerson is 1639230428. It was assigned to this individual provider in the NPPES registry on December 13, 2006. The provider is also known as Mrs. Tamara Dickerson Brackin Aa-C.

Where is Tamara Dickerson located?

Tamara Dickerson practices at 677 Church St NE, Marietta, GA 30060. The listed phone number is (770) 794-0477.

What is Tamara Dickerson's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Tamara Dickerson enrolled in Medicare?

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

Which organizations bill Medicare for Tamara Dickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tamara Dickerson reassigns Medicare benefits to 3 organizations: Wellstar Medical Group, LLC (Marietta, GA), Mak Anesthesia Holdings LLC (Kennesaw, GA) and Georgia Anesthesiologists, PC (Woodstock, GA). 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 Tamara Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tamara Dickerson accept?

Health plans from Alliant Health Plans, Inc. and Oscar Health list Tamara 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 Tamara Dickerson affiliated with any hospitals?

According to CMS data, Tamara Dickerson is affiliated with Wellstar Kennestone Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Tamara Dickerson was last updated on July 6, 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.