SAMUEL DAVID DICKERSON
NPI 1801651765
General Practice in Tacoma, WA
About Samuel David Dickerson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL DAVID DICKERSON (NPI 1801651765) is an individual general practice provider in Tacoma, Washington, licensed in Virginia (0101288217) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samuel David Dickerson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
TACOMA, WA 98431
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 Samuel Dickerson's NPI number?
The NPI number for Samuel Dickerson is 1801651765. It was assigned to this individual provider in the NPPES registry on February 19, 2024.
Where is Samuel Dickerson located?
Samuel Dickerson practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-1420.
What is Samuel Dickerson's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Samuel Dickerson enrolled in Medicare?
Yes. Samuel Dickerson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Samuel Dickerson was last updated on January 28, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.
