Individual provider Active NPI

Jessica Dixon-Tatum, LPN

  • Nursing Care Agency
  • Buckeye, AZ
National Provider Identifier
1033757877
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
8900919 Issued in AZ
Practice address
401 N 6TH St
Buckeye, AZ 85326-2415
Phone
(623) 401-6331
Fax
(623) 233-6331
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP040900 AZ
Nursing Care Agency 251J00000X 8900919 AZ Primary
Home Health Agency 251E00000X 8900919 AZ
Foster Care Agency 253J00000X 8900919 AZ
Child Mental Illness Respite Care 385HR2055X 8900919 AZ

Addresses

Primary practice location

401 N 6TH St
Buckeye, AZ 85326-2415

Mailing address

401 N 6TH St
Buckeye, AZ 85326-2415
Phone (623) 698-8210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP040900AZMDLicensed Practical Nurse
8900919AZMDNursing Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Happy's Home LLC Licensed Practical Nurse Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1033757877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 6TH ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853262415",
            "telephone_number": "623-698-8210",
            "fax_number": "602-455-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 6TH ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853262415",
            "telephone_number": "623-401-6331",
            "fax_number": "623-233-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON-TATUM",
        "first_name": "JESSICA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP040900",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AZ",
            "license": "8900919",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "8900919",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "AZ",
            "license": "8900919",
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "8900919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.