Casey Dix, NP
Individual provider Active NPI Family Nurse Practitioner · MC Rae, GA
NPI 1013539899 · NPPES record last updated May 18, 2020
Key facts
- NPI
- 1013539899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN220968 (GA)
- Practice address
- 23 W Martin Luther King Jr Blvd
MC Rae, GA 31055-4150 - Phone
- (229) 947-4071
- NPI assigned
- May 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200624000592 | GA | Practitioner - Nurse Practitioner | 5395167142 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Wellness Center of Georgia, LLC | Current |
Accepting new patients | |
| South Central Primary Care Center, Inc | Past | Accepting new patients | |
| South Central Primary Care Center, Inc | Past | Accepting new patients | |
| South Central Primary Care Center, Inc | Past | Accepting new patients |
Locations
77 N Main St
Ste B
Baxley, GA 31513
Phone (912) 208-3824
23 W Martin Luther King Jr Blvd
Mc Rae Helena, GA 31055
Phone (229) 562-3800
1523 Old Valdosta Rd
Ray City, GA 31645
Phone (877) 543-7221
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDFABA/Endpoint/GDFABA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN220968 | GA | Yes |
Addresses
Primary practice location
23 W Martin Luther King Jr Blvd
MC Rae, GA 31055-4150
Mailing address
PO Box 692
Ocilla, GA 31774-0692
Phone (229) 425-2539
Other providers in MC Rae, GA
- Bryant Keith Barrows
- Richard Erwin Bass
- Bryant K Barrows DMD PC
- Community Health Care Systems, Inc
- Kelly Hamilton Deloach
- Megan Deanna Dowdy
- Dr. Griffin E. Mizell D.D.S
- Clayton Kyle Ellis
- Golden Isles Healthcare,LLC
- Rebecca Knowles Greene
All providers in MC Rae, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.