Dickson Psychiatric Services, PLC – Family Nurse Practitioner, NPI 1295167880
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Dickson Psychiatric Services, PLC
1409 WILLOW ST STE 201
MINNEAPOLIS, MN 554033254
Phone: (763) 200-6161
Fax: (877) 514-9201
Type: Location
2002 CROMWELL
GRAND RAPIDS, MN 557443571
Phone: (218) 256-7570
Fax: (877) 514-9201
Type: Location
100 COLE ST
PO BOX 688
COLERAINE, MN 55722
Phone: (218) 256-7570
Fax: (877) 514-9201
Type: Mailing
6357 MERRIMAC LN N
MAPLE GROVE, MN 553113835
Phone: (218) 256-7570
Fax: (877) 514-9201
Type: Mailing
4300 BAKER RD STE 200
MINNETONKA, MN 553438688
Phone: (763) 200-6161
Fax: (877) 514-9201
Type: Location
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: 2013-08-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (833 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20130821001050 | O | Clinic/Group Practice | MN | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 55403)
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