MRS. CHENOA DICKERSON (FNP-C) – Family Nurse Practitioner, NPI 1063002145

MRS. CHENOA DICKERSON (FNP-C) is a healthcare provider. based in Lawrenceville, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. RN248353 (GA). The NPI Number for MRS. CHENOA DICKERSON (FNP-C) is 1063002145

Main info

Female
6 Years Of Experience
Name
MRS. CHENOA DICKERSON (FNP-C)
NPI
1063002145
Phone
(706) 962-3642
Address
455 PHILIP BLVD STE 140
Enumeration Date
22 January 2021
Last Update Date
16 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7709623642
Graduation Year
2020 (6 years ago)
PAC ID
3072909654
Group Practice PAC ID
8527200864
Professional Enrollment ID
I20220407000986
Address ID
GA307208394DA1504XAVEX404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:5State licenses:2Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MRS. CHENOA DICKERSON (FNP-C)

  • 455 PHILIP BLVD STE 140

    LAWRENCEVILLE, GA 300468768

    Phone: (706) 962-3642

    Type: Mailing

  • 18 RIVERBEND DR SW STE 118

    ROME, GA 301616019

    Phone: (706) 962-3642

    Type: Location

  • 63 ROBIN RD

    ADAIRSVILLE, GA 301034600

    Phone: (706) 669-5243

    Type: Mailing

  • 1504 N THORNTON AVE STE 103

    DALTON, GA 307208394

    Phone: (706) 510-0002

    Type: Location

  • 1504 N Thornton Ave Ste 103

    Dalton, GA 307208394

    Phone: (706) 510-0002

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 56 Open Payments records for all available years, with a total value of $2,143.

Total Amount is formed as General ($2,143) + Research ($0) + Ownership ($0) = $2,143.

Last reported payment date: 2024-12-07 • Largest payer in this snapshot: Medtronic, Inc. ($1,343).

Total Amount

$2,143

General + Research + Ownership

Payments

56

Total payment records

General Amount

$2,143

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-07

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220407000986INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30046)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527200864View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Interventional Pain ManagementMS
Nurse PractitionerGA
Physician AssistantGA
Neurology, Pain Management, Pain ManagementTN
Physician AssistantGA
Anesthesiology, Pain ManagementGA
Nurse PractitionerGA

Reviews

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Frequently asked questions

What number should I use to identify MRS. CHENOA DICKERSON (FNP-C) for billing?
Administrative and clinical systems typically use NPI 1063002145 for MRS. CHENOA DICKERSON (FNP-C).
Should I treat MRS. CHENOA DICKERSON (FNP-C) as an active provider?
Patients and plans typically see MRS. CHENOA DICKERSON (FNP-C) as active in the national extract.
How should patients interpret MRS. CHENOA DICKERSON (FNP-C)'s specialty?
The extract shows Family Nurse Practitioner for MRS. CHENOA DICKERSON (FNP-C). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. CHENOA DICKERSON (FNP-C)?
MRS. CHENOA DICKERSON (FNP-C) is associated with Lawrenceville, Georgia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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