Kelcie Dickerson, PA is a medicare enrolled "Physician Assistant" in Lyman, Wyoming. Her current practice location is
3580 State Highway 414, Lyman, Wyoming. You can reach out to her office (for appointments etc.) via phone at
(307) 786-2042.
Kelcie Dickerson is licensed to practice in Wyoming (license number PT607) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992105696.
Provider's Profile
Full Name | Kelcie Dickerson |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 3580 State Highway 414, Lyman, Wyoming |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1992105696
- Provider Enumeration Date: 08/29/2014
- Last Update Date: 08/29/2014
Medicare PECOS Information:
- PECOS PAC ID: 5890018816
- Enrollment ID: I20160218000907
Medical Identifiers
Medical identifiers for Kelcie Dickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992105696 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PT607 (Wyoming) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelcie Dickerson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelcie Dickerson, PA 740 S Woodruff Ave, Idaho Falls, ID 83401-5285 Ph: (208) 542-9111 | Kelcie Dickerson, PA 3580 State Highway 414, Lyman, WY 82937-0001 Ph: (307) 786-2042 |
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