NPPES file of Aug 9, 2026

Ty Dickerson, M.D.

Pediatrics Physician · Salt Lake City, UT

Ty Dickerson, M.D. is a pediatrics physician with a practice address in Salt Lake City, Utah, and NPI 1639102684, issued on Jul 9, 2006. Check the license (Utah 6279497-1205, as entered in NPPES) on the Utah Medical Licensing Board; the federal record below is the public data PlainDoctor holds for this provider.

Record from CMS NPPES, file of Aug 9, 2026 · method · Verify with CMS →

NPPES recordNPPES file of Aug 9, 2026
1639102684
Name
Ty Dickerson
Credential
M.D.
Primary taxonomy
Pediatrics Physician 208000000X
License number
6279497-1205 UT
Self-reported in NPPES; status is on the state search
Practice location
100 N Medical Dr, Salt Lake City, UT 84113
Phone
(801) 588-3813
Enumerated
Jul 9, 2006
Record last updated
Oct 20, 2021 (not updated in 5 years: call before relying on the address or phone)
Medicaid ID
02181735 NY
Entity
Type 1 · individual
Public record from CMS NPPES (open it on the CMS NPI Registry). A record is not a license: verify it with the state board.
Download card Updates feed

8 nearest pediatrics physician records → All 670 in Utah → Look up another NPI →

Also registered at 100 N Medical Dr

A shared address usually means a shared clinic or building; it does not show who employs whom.

  1. Kwabena AmpofoPediatric Infectious Diseases Physician1629157193
  2. Barry Anderton, MDAnesthesiology Physician1962517961
  3. Ronald Apfelbaum, MDNeurological Surgery Physician1891885422
  4. Mariana Baserga, M.D.Neonatal-Perinatal Medicine Physician1083788178
  5. Anne Blaschke-Bonkowsky, MDPediatric Infectious Diseases Physician1760435325
  6. Stephanie Bodily, FNPFamily Nurse Practitioner1073708095

Verify Ty Dickerson in five checks

  1. 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
  2. 2LicenseActive license and public ordersUtah Medical Licensing Board
    Search for license 6279497-1205    Check the board
  3. 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
  4. 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
  5. 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Open the Utah license search

PlainDoctor does not match the HHS-OIG exclusion list to individual records: most entries carry no NPI. Search the OIG exclusion list by name.

Is this page about you? You can ask us to correct, restrict or remove it: how.

Ty Dickerson among 670 pediatrics physician records in Utah

Ty Dickerson, M.D. is one of 670 pediatrics physician records with a practice address in Utah. 37% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2006, is newer than 11% of them.

  • NPI issued2006 · 11% of these records are older, 58% newer
  • In a Medicare fileNo · 37% of these records are
  • In the CMS Doctors and Clinicians fileNo · 9% of these records are
  • Record last updated2021 · 62% of these records were not updated in five years or more

Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 208000000X and a Utah practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).

283 pediatrics physician records list a practice address in Salt Lake City

They are 283 of the 21,563 NPPES records with a practice address in Salt Lake City, and 670 pediatrics physician records in Utah. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.

All 670 in Utah → Every provider in Salt Lake City → Pediatrics Physician nationwide →

The 8 pediatrics physician records with the nearest ZIP codes

  1. Jennifer Brinton, M.D.Salt Lake City, UT 841131457368946
  2. Claudia Fruin, MDSalt Lake City, UT 841131619959319
  3. Per Gesteland, MDSalt Lake City, UT 841131821195371
  4. Richard Greenberg, MDSalt Lake City, UT 841131154402949
  5. Gregory Harlan, MD MPHSalt Lake City, UT 841131437238904
  6. Benjamin Kalm, M.D.Salt Lake City, UT 841131427130285
  7. William McDonnellSalt Lake City, UT 841131699729384
  8. Christopher Miller, MDSalt Lake City, UT 841131447340054

Common questions

What is Ty Dickerson, M.D.'s NPI number?

Ty Dickerson, M.D.'s National Provider Identifier (NPI) is 1639102684, issued on Jul 9, 2006. An NPI identifies a provider in billing; it is not a license.

Where is Ty Dickerson, M.D. located?

The NPPES record lists a practice address at 100 N Medical Dr, Salt Lake City, UT, 84113. Phone: (801) 588-3813. Providers update this record themselves, so call before visiting.

How can I verify Ty Dickerson, M.D.'s license?

NPPES lists Utah license number 6279497-1205, as entered by the provider. Search the Utah Medical Licensing Board at https://secure.utah.gov/llv/search/index.html. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.

Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.

Written with AI tools from the named public files; every figure is computed from those files (how it is made).

Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.