Individual Healthcare Provider
Derryl S. Dickerson, DC, PTA
Provider's NPPES record last updated: May 21, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1316253107
- Primary Specialty
- Chiropractor — Rehabilitation
- Practice Location
- Marietta, Georgia
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 9:28 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Chiropractor
Rehabilitation
Chiropractic Providers
Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an individual participates in. Relevant impairments (e.g. strength, endurance, flexibility, motor control, etc.) are often intermediate goals of rehabilitation, but the final goal of successful care is return to participation in activities in which the patient was successful before the onset of the injury or disease. Essential to a rehabilitation approach is a focus on patient-centered outcomes such as independence and self-management or self-care skills.
Taxonomy code 111NR0400X Physical Therapy Assistant
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient's responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life.
Taxonomy code 225200000X
Provider-Reported License Information
- Chiropractor (Georgia)
- CHIR010363
- Physical Therapy Assistant (Georgia)
- PTA002699
Practice Locations
Practice Location
2850 Johnson Ferry Rd Ste 150
Marietta, Georgia 30062-8317
Phone: (770) 518-8786
Additional Practice Location
3890 Redwine Rd Sw
Suite 114
Atlanta, Georgia 30331-5582
Phone: (404) 344-7880
Fax: (404) 344-7881
Record Information
- Enumeration Date
- August 31, 2010
- Provider's NPPES Record Last Updated
- May 21, 2020
- Certification Date
- May 21, 2020
- NPISignal NPPES Dataset
- August 2026
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