Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Mandy Marie Dickerson , NP

Nurse Practitioner β€’ Port Huron, MI

Active NPI 1336699958 Individual Practitioner Female Practitioner
Practice location in NPPES

1321 Stone, Bw Childrens Health Care
Port Huron, MI 48060

Call 8109841000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1321 Stone
Bw Childrens Health Care

Port Huron, MI 48060

Telephone 8109841000

Industry payments (Open Payments)

Fewer than 11 payment records totaling $50.52 in 2025

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2025.

Guide: How to read an Open Payments record

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Mandy Dickerson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Mandy Dickerson as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Port Huron and Michigan

21 active clinicians are listed under Nurse Practitioner with a practice address in Port Huron, MI (3,576 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Port Huron

14.3% of these 21 clinicians have the CMS telehealth indicator.

47.6% of these 21 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $50.52.

Manufacturer Payment Nature Product Type Amount ($)
Seqirus USA Inc
Food and Beverage
In-kind items and services
β€” General $50.52

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-12-28
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

License # reported to NPPES MI 4704275005

(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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - NURSE PRACTITIONER

Medicare Enrollment ID

I20170131001520

Enrollment State Jurisdiction

MI

PECOS Control ID

9830471689

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ“
Updated Practice Location October 02, 2024

Registered at 1321 STONE, BW CHILDRENS HEALTH CARE, PORT HURON, MI 48060 (Tel: 8109841000)

πŸ“
Updated Business Mailing Address October 02, 2024

Registered at 1321 STONE STREET, PORT HURON, MI 48060 (Tel: 8109841000)

πŸ‘€
Provider Name / Credentials Updated October 02, 2024

Recorded as MANDY DICKERSON, NP

πŸ“
Updated Business Mailing Address December 28, 2020

Registered at 3621 S STATE ST, ANN ARBOR, MI 481081633 (Tel: 7346475299)

βœ…
NPI Profile Active January 23, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location January 23, 2017

Registered at 6655 NEFF RD, MOUNT MORRIS, MI 48458 (Tel: 7349982161)

πŸ“
Updated Business Mailing Address January 23, 2017

Registered at 3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108 (Tel: 7349362047)

πŸ‘€
Provider Name / Credentials Updated January 23, 2017

Recorded as MANDY LYON, NP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2017

Nurse Practitioner (license number reported to NPPES: MI 4704275005)

βœ…
NPI Profile Active October 06, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 06, 2016

Registered at 2502 S ROCHESTER RD, ROCHESTER HILLS, MI 483073817 (Tel: 2488525177)

πŸ“
Business Mailing Address (Initial Record) October 06, 2016

Registered at 2502 S ROCHESTER RD, ROCHESTER HILLS, MI 483073817 (Tel: 2488525177)

πŸ‘€
Provider Name / Credentials (Initial Record) October 06, 2016

Recorded as MANDY LYON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2016

Clinical Nurse Specialist (license number reported to NPPES: MI 4704275005)

🟒
Initial NPI Registration & Enumeration October 06, 2016

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1336699958
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2016
Last Update: October 02, 2024
Sole Proprietor: No

Other Nurse Practitioners in Port Huron

All Nurse Practitioners in Port Huron

Mailing Address

1321 Stone Street

Port Huron, MI 48060

Phone: 8109841000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.