Individual provider Active NPI

Patricia Ann Dixon

  • Primary Care Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1043903016
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
170711 Issued in FL
Practice address
673 S Kings Ave
Brandon, FL 33511-6048
Phone
(813) 842-8662
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 170711 FL Primary

Addresses

Primary practice location

673 S Kings Ave
Brandon, FL 33511-6048

Mailing address

673 S Kings Ave
Brandon, FL 33511-6048
Phone (813) 842-8662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206001689 FL Practitioner - Nurse Practitioner 3274976386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accountable Inpatient MedicineGroup PAC ID 5597090274, 51 clinicians

Practice addresses (Care Compare)

8130 Lakewood Main St
Suite 103
Lakewood Ranch, FL 34202-5068

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
170711FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wanderlust Experience Single Specialty CurrentSince May 28, 2023 Accepting new patients
Accountable Inpatient Medicine Single Specialty CurrentSince Nov 26, 2023 Accepting new patients

Locations

673 S Kings Ave
Brandon, FL 33511
Phone (251) 610-5615

8130 Lakewood Main St
Ste 103
Lakewood Ranch, FL 34202
Phone (918) 289-7085

8433 Enterprise Cir
Ste 100
Lakewood Ranch, FL 34202
Phone (941) 499-2700

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1043903016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116048",
            "telephone_number": "813-842-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116048",
            "telephone_number": "813-842-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "170711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.