Blake Dixon, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5030 Issued in KY

Practice address

350 Hospital Way Ste 100
Somerset, KY 42503-1872

Phone

(606) 451-2600

Fax

(606) 451-2651

NPI assigned

Apr 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Champion Physical Therapy Kentucky, LLCGroup PAC ID 3476818519, shared by 3 NPIs, 43 clinicians

Lake Cumberland Regional Hospital LLCGroup PAC ID 7214909456, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Family Home Health Care, LLC Dba Adoration Home Health Home health agency, Columbia, KY, CCN 187119
• Lifeline Health Care of Pulaski Home health agency, Somerset, KY, CCN 187099
• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4
• Direct secure messaging: blake.dixon.1@21269.direct.athenahealth.com

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

• Lake Cumberland Regional Hospital LLC

  • Internal Medicine Physician
  • Somerset, KY
  • NPI 1861078685

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lake Cumberland Regional Hospital LLC

  • Rural Health Clinic/Center
  • Somerset, KY
  • NPI 1023155462
  NPD
• Lake Cumberland Regional Hospital, LLC

  • Internal Medicine Physician
  • Somerset, KY
  • NPI 1447330451

  Family Medicine

  NPD
• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Family Home Health Care LLC

  • Home Health Agency
  • Columbia, KY
  • NPI 1891765723
  Care Compare affiliation
• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Lifeline Home Health Care of Somerset, LLC

  • Home Health Agency
  • Somerset, KY
  • NPI 1114951993
  Care Compare affiliation

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1033772199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 JUSTICE WAY APT 409",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415018314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HOSPITAL WAY STE 100",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031872",
            "telephone_number": "606-451-2600",
            "fax_number": "606-451-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "BLAKE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R5030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Jean Dishman, LCSW
• Diana Dishman
• Lee Anne Dishman, MASTER OF ARTS
• Christopher Disimile, CRNA
• Divine Pathways LLC
• Jason Dixon, APRN
• Jennifer Darlene Dixon, RN, CDCES
• Jonathan Barry Dixon, M.D.
• Valerie Shaelyn Eversole Dixon, DO
• Michelle Dockery, PTA

• Family Medicine Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.