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Active NPI 1902139447 Individual Practitioner Male Practitioner

Samuel Emmanuel Dickerson , LPN

Licensed Practical Nurse • Roosevelt, NY

Professional Overview & Biography Verified Profile Summary

Samuel Dickerson, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Roosevelt, NY. Practice services are available at 95 W GREENWICH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

95 W Greenwich Ave

Roosevelt, NY 115751035

Telephone 5164813421
Fax 5166653798

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Roosevelt, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
51 Specialists

Practicing in Roosevelt, NY (23738 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NY 241150-1

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active September 16, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location September 16, 2009

Registered at 95 W GREENWICH AVE, ROOSEVELT, NY 115751035 (Tel: 5164813421)

📍
Updated Business Mailing Address September 16, 2009

Registered at 95 W GREENWICH AVE, ROOSEVELT, NY 115751035 (Tel: 5164813421)

👤
Provider Name / Credentials Updated September 16, 2009

Recorded as SAMUEL DICKERSON, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2009

Licensed Practical Nurse (License #241150-1 in NY)

🟢
Initial NPI Registration & Enumeration September 16, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902139447
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2009
Last Update: September 16, 2009
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

95 W Greenwich Ave

Roosevelt, NY 115751035

Phone: 5164813421

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.