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Deactivated NPI 1154913440 Deactivated / Inactive NPI Male Practitioner

Derek Lamar Dickerson

Peer Specialist • Chattanooga, TN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Derek Dickerson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 08, 2021
NPI Deactivation Date December 20, 2023
Total Practice Duration ~2 Years of Practice (2021 – 2023)

Professional Overview & Biography Verified Profile Summary

Derek Dickerson was a registered Peer Specialist practicing in Chattanooga, TN. Throughout an active medical career spanning 2 years, Derek Dickerson provided care at the practice location at 509 S HIGHLAND PARK AVE until profile deactivation on 2023-12-20.

Practice Location & Contact Primary Location

Practice Address

509 S Highland Park Ave

Chattanooga, TN 374042932

Telephone 4232666751
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Chattanooga, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
19 Specialists

Practicing in Chattanooga, TN (165 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

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003200510
Brendin Rogers

Case Manager/Care Coordinator

NPI 1003371816
Christopher Wyatt

Peer Specialist

NPI 1003380916
Joanna Swanson , RN

Registered Nurse - Psychiatric/Mental Health

NPI 1003426941

Registered Nurse

Claudia May

Behavior Technician

NPI 1003621509
Wendy Kirkpatrick-Hamlet

Case Manager/Care Coordinator

NPI 1013036698

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated December 20, 2023

Record deactivated on December 20, 2023

NPI Profile Active February 08, 2021

NPI status registered as active in NPPES database

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Updated Practice Location February 08, 2021

Registered at 509 S HIGHLAND PARK AVE, CHATTANOOGA, TN 374042932 (Tel: 4232666751)

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Updated Business Mailing Address February 08, 2021

Registered at 200 TECH CENTER DR, KNOXVILLE, TN 379122747 (Tel: 8656379711)

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Provider Name / Credentials Updated February 08, 2021

Recorded as DEREK DICKERSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2021

Peer Specialist

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Initial NPI Registration & Enumeration February 08, 2021

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: 1154913440
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 08, 2021
Last Update: February 08, 2021
Deactivation Date: December 20, 2023

Mailing Address

200 Tech Center Dr

Knoxville, TN 379122747

Phone: 8656379711

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.