Active NPI
Willie N Dixon
- Assisted Living Facility
- Wilson, NC
National Provider Identifier
1003099029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- FCL-098-009
- Legal business name
- WILLIE N DIXON
- Practice address
- 2817 Tilghman Rd N
Wilson, NC 27896-8908 - Phone
- (252) 243-9827
- Fax
- (252) 291-9448
- NPI assigned
- Dec 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Willie N Dixon
- Title
- Owner
- Phone
- (252) 243-9827
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | FCL-098-009 | NC | Primary |
Addresses
Primary practice location
2817 Tilghman Rd N
Wilson, NC 27896-8908
Mailing address
2817 Tilghman Rd N
Wilson, NC 27896-8908
Phone (252) 243-9827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7801424 | Medicaid | NC |
Other names 1
- Shepherd Grove Family Care
National Provider Directory
National Provider Directory- Tax ID family
- Shepherd Grove Family Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Wilson, NC
- NPI 1730362757
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Assisted Living Facility
- Wilson, NC
- NPI 1063544096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197504000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214179200000",
"number": "1003099029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 TILGHMAN RD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278968908",
"telephone_number": "252-243-9827",
"fax_number": "252-291-9448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 TILGHMAN RD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278968908",
"telephone_number": "252-243-9827",
"fax_number": "252-291-9448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLIE N DIXON",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-13",
"last_updated": "2008-06-23",
"status": "A",
"authorized_official_last_name": "DIXON",
"authorized_official_first_name": "WILLIE",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "252-243-9827",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NC",
"license": "FCL-098-009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7801424",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Shepherd Grove Family Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.