ANNETTE FLUELLEN DICKERSON (P.A.) – Physician Assistant, NPI 1114113362

ANNETTE FLUELLEN DICKERSON (P.A.) is a healthcare provider. based in Atlanta, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 007865 (GA). The NPI Number for ANNETTE FLUELLEN DICKERSON (P.A.) is 1114113362

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
ANNETTE FLUELLEN DICKERSON (P.A.)
NPI
1114113362
Phone
(404) 851-6000
Address
980 JOHNSON FERRY RD STE 940
Enumeration Date
21 September 2007
Last Update Date
1 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4047787525
Graduation Year
2007 (19 years ago)
PAC ID
1759465750
Group Practice PAC ID
8820901408
Professional Enrollment ID
I20160317001411
Address ID
GA303221013AT1365XNEXX400
Telehealth
Yes

Contacts

Secure Messaging
annette.dickersonpac.d1.p1@direct.gacancer.nextgenshare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

4,430 PHYSICIAN ASSISTANT in GA

Provider Addresses for ANNETTE FLUELLEN DICKERSON (P.A.)

  • 980 JOHNSON FERRY RD STE 940

    ATLANTA, GA 303421609

    Phone: (404) 851-6000

    Fax: (404) 252-2736

    Type: Location

  • 95, Collier Road Northwest, A, Atlanta, Georgia, 30309, United States

    SUITE 5015

    ATLANTA, GA 303091796

    Phone: (404) 605-2800

    Fax: (404) 351-5983

    Type: Mailing

  • 2736 BELL DR SE

    SMYRNA, GA 300802602

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $365.

Total Amount is formed as General ($365) + Research ($0) + Ownership ($0) = $365.

Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($64).

Total Amount

$365

General + Research + Ownership

Payments

12

Total payment records

General Amount

$365

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-24

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: 2016-03-17

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
I20160317001411IPhysician AssistantGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99215Established patient office or other outpatient visit, 40-54 minutes13485$0
99214Established patient office or other outpatient visit, 30-39 minutes5129$0
View full utilization report →

Insurance plans in this area (ZIP 30342)

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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: 8820901408View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineCA
Internal MedicineGA
Physician AssistantFL
Interventional Radiology, Diagnostic RadiologyKY
Anesthesiology AssistantGA
-CA
D E R M A T O L O G YGA
Interventional Radiology, Diagnostic RadiologyNC
Physician AssistantGA
-GA

Reviews

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Frequently asked questions

How is ANNETTE FLUELLEN DICKERSON (P.A.) identified in CMS data?
CMS-hosted NPPES data lists ANNETTE FLUELLEN DICKERSON (P.A.) with NPI 1114113362.
Does CMS list ANNETTE FLUELLEN DICKERSON (P.A.) as active?
Yes — ANNETTE FLUELLEN DICKERSON (P.A.) is active in the NPI listing used on this page.
What healthcare role does ANNETTE FLUELLEN DICKERSON (P.A.) hold?
Scheduling teams often label ANNETTE FLUELLEN DICKERSON (P.A.) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Does ANNETTE FLUELLEN DICKERSON (P.A.) list a practice location?
Patients near Atlanta, Georgia may find ANNETTE FLUELLEN DICKERSON (P.A.) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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