Jacob Edward Dickerson, DNAP
NPI 1013659960ActiveIndividual· Nurse Anesthetist, Certified Registered· Tahlequah, OK
Nurse Anesthetist, Certified Registered (DNAP) in Tahlequah, Oklahoma, licensed in OK, with an NPI issued in April 2022. Medicare paid $6,167 for services to 78 patients in 2024.
Overview
| NPI | 1013659960 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DNAP |
| Sole proprietor | Yes |
| NPI issued | Apr 11, 2022 |
| Last updated in NPPES | Jul 10, 2022 |
| Certified by provider | Jul 10, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 208980 | OK |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 78 |
|---|---|
| Services billed | 80 across 18 procedure codes |
| Paid by Medicare | $6,167 |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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