Individual provider Active NPI

Crystal Danielle Dixon, FNP

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1053117903
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30006 Issued in SC
Practice address
279 E Kennedy St
Spartanburg, SC 29302-1912
Phone
(864) 583-0053
Fax
(864) 583-0390
NPI assigned
Feb 21, 2025
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30006 SC Primary

Addresses

Primary practice location

279 E Kennedy St
Spartanburg, SC 29302-1912

Mailing address

279 E Kennedy St
Spartanburg, SC 29302-1912
Phone (864) 583-0053

Other identifiers 1

IdentifierTypeStateIssuer
NN1118MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20260130001671 SC Practitioner - Nurse Practitioner 1254819386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Pain Associates PLLCGroup PAC ID 0941441919, 156 clinicians

Practice addresses (Care Compare)

279 E Kennedy St
Spartanburg, SC 29302-1912
Phone (864) 583-0053

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30006SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pain Associates PLLC CurrentSince Jan 14, 2026 Accepting new patients
Commonwealth Pain Associates, PLLC Family CurrentSince Jan 14, 2026 Accepting new patients
Memorial Drive Medical PC, LLC Past Accepting new patients

Locations

120 Executive Park
St Matthews, KY 40207
Phone (502) 409-9925

1506 N Fant St
Anderson, SC 29621
Phone (864) 260-6995

7021 Saint Andrews Rd
Ste 1
Columbia, SC 29212
Phone (803) 749-7751

127 Ben Casey Dr
Ste 103
Fort Mill, SC 29708
Phone (502) 885-7200

10 Enterprise Blvd
Ste 201
Greenville, SC 29615
Phone (864) 234-7815

805 Montague Ave
Greenwood, SC 29649

279 E Kennedy St
Spartanburg, SC 29302
Phone (864) 583-0053

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1053117903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E KENNEDY ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021912",
            "telephone_number": "864-583-0053",
            "fax_number": "864-583-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 E KENNEDY ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021912",
            "telephone_number": "864-583-0053",
            "fax_number": "864-583-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "CRYSTAL",
        "middle_name": "DANIELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NN1118",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.