Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1093608515 Individual Practitioner Female Practitioner

Jordan Danielle Dickerson , NP

Nurse Practitioner • Tyler, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jordan Dickerson, NP is a certified Nurse Practitioner practicing in Tyler, TX. With approximately 2 years of clinical experience since completing medical education in 2024, Jordan Dickerson delivers high-quality medical care to the local community at 912 S FLEISHEL AVE.

Jordan Dickerson is affiliated with Etmc Physician Group, Inc. and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

912 S Fleishel Ave

Tyler, TX 757012018

Telephone 9035926901
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2024

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Tyler, TX

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
2 Yrs -7.7 yrs vs City Avg
City Avg: 9.7 Yrs
State Avg: 9.7 Yrs
Regional Practice Density
148 Specialists

Practicing in Tyler, TX (4894 Statewide)

Telehealth Adoption Rate
11.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dickerson (2 Years) 2 Yrs
Tyler Specialty Average (9.7 Years) 9.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-07-15
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License TX 1204964

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Etmc Physician Group, Inc.

912 S Fleishel Ave, Tyler, TX 757012018

Phone: 9035926901

Practice Associates & Co-Workers

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

22 Associated Practitioners
Dr. Varalaxmi Nannaka , MD

Internal Medicine - Pulmonary Disease

NPI 1003198391

Doctor of Medicine (M.D.)

Naomi Wallace , NP

Nurse Practitioner

NPI 1013699131

Nurse Practitioner

Dr. Joseph Gatuz , MD

Internal Medicine - Pulmonary Disease

NPI 1073005880

Doctor of Medicine (M.D.)

Kimberly Brown , FNP

Nurse Practitioner

NPI 1083084537

Family Nurse Practitioner

Dr. Carla Wang-Kocik , MD

Internal Medicine - Pulmonary Disease

NPI 1093948333

Doctor of Medicine (M.D.)

Cynthia Chaney , NP

Nurse Practitioner - Family

NPI 1114137262

Nurse Practitioner

Career & Practice History Timeline

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

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2025

Nurse Practitioner (License #1204964 in TX)

NPI Profile Active June 02, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2025

Registered at 912 S FLEISHEL AVE, TYLER, TX 757012018 (Tel: 9035926901)

📍
Updated Business Mailing Address June 02, 2025

Registered at 912 S FLEISHEL AVE, TYLER, TX 757012018 (Tel: 9035926901)

👤
Provider Name / Credentials Updated June 02, 2025

Recorded as JORDAN DICKERSON, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2025

Registered Nurse (License #983459 in TX)

🟢
Initial NPI Registration & Enumeration June 02, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jordan Dickerson. Be the first to share your experience!

Sign in to leave a review for Jordan Dickerson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1093608515
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2025
Last Update: July 15, 2025
Sole Proprietor: No

Mailing Address

912 S Fleishel Ave

Tyler, TX 757012018

Phone: 9035926901

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.