MARY S S DICKERSON (OT) – Occupational Therapist, NPI 1184758336

MARY S S DICKERSON (OT) is a healthcare provider. based in Newnan, Georgia. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OT. They hold a License No. OT003143 (GA). The NPI Number for MARY S S DICKERSON (OT) is 1184758336

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
MARY S S DICKERSON (OT)
NPI
1184758336
Phone
(770) 254-7850
Address
1755 HIGHWAY 34 E
Enumeration Date
16 March 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7067543167
Graduation Year
1985 (41 years ago)
PAC ID
4385028703
Group Practice PAC ID
5890692917
Professional Enrollment ID
I20220903000258
Address ID
GA305354578DE225XXDRXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

486 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for MARY S S DICKERSON (OT)

  • 1755 HIGHWAY 34 E

    SUITE 1300

    NEWNAN, GA 302655631

    Phone: (770) 254-7850

    Type: Location

  • 3150 HIGHWAY 34 E STE 140

    NEWNAN, GA 302652121

    Phone: (770) 251-2060

    Fax: (770) 251-8567

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-09-03

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
I20220903000258IOccupational Therapist In Private PracticeGATBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes23425$0
97140Therapy procedure using manual technique, each 15 minutes23326$0
97530Therapy procedure using functional activities9717$0
97165Evaluation for occupational therapy, typically 30 minutes1513$0
View full utilization report →

Insurance plans in this area (ZIP 30265)

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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: 5890692917View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
-GA

Reviews

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Frequently asked questions

What unique ID ties claims to MARY S S DICKERSON (OT)?
NPI 1184758336 is assigned to MARY S S DICKERSON (OT) under the national enumeration system.
Is MARY S S DICKERSON (OT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MARY S S DICKERSON (OT)'s specialty in plain language?
Clinically, the directory lists MARY S S DICKERSON (OT) with Occupational Therapist. Clinical services aligned with this taxonomy classification.
Does MARY S S DICKERSON (OT) practice in Georgia?
You will see Newnan, Georgia on file for MARY S S DICKERSON (OT) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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