Kelcie Dickerson, PA is a medicare enrolled "Physician Assistant" in Lyman, Wyoming. She graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice St Lukes Clinic Llc and 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
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and 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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| Experience | 12 Years |
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| Location | 3580 State Highway 414, Lyman, Wyoming |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelcie Dickerson graduated from nursing school in 2014
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 |
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| 363A00000X | Physician Assistant | PT607 (Wyoming) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| St Lukes Clinic Llc | 1052217478 | 294 |
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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