Etosha D Dixon, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

D61785 Issued in MD

Practice address

8800 Walther Blvd
Baltimore, MD 21234-9001

Phone

(410) 882-3240

Fax

(410) 661-5093

NPI assigned

Apr 1, 2006

Last updated

Apr 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Medstar Urgent Care LLC

  dba MedStar PromptCare

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment NPD
• Medstar Urgent Care, LLC

  dba MedStar PromptCare-Wheaton

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment NPD
• On-Time Medical Group Inc

  • Primary Care Clinic/Center
  • Randallstown, MD
  • NPI 1023854155
  Medicare reassignment NPD
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  dba MMG Urgent Care

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD
• On-Time Medical Group Inc

  • Urgent Care Clinic/Center
  • Randallstown, MD
  • NPI 1336975648
  NPD
• On-Time Medical Group Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Randallstown, MD
  • NPI 1831916535
  NPD
• Doctors' Billing & Management Solutions, Inc

  • Point of Service
  • Glen Burnie, MD
  • NPI 1578516183
  NPD (past)
• Physicians' House Calls

  • Contractor
  • Glen Burnie, MD
  • NPI 1346315827
  NPD (past)
• University Care

  • Health Service Psychologist
  • Baltimore, MD
  • NPI 1629210166
  NPD (past)
• University Care LLC

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1497760276
  NPD (past)

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1063473551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "410-402-2379",
            "fax_number": "410-463-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 WALTHER BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212349001",
            "telephone_number": "410-882-3240",
            "fax_number": "410-661-5093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4538 Edmondson Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212291506",
            "country_code": "US",
            "telephone_number": "410-328-2273",
            "fax_number": "410-362-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "ETOSHA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-01",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "22045",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D61785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805701000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-DC",
            "identifier": "T016-0057",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "0056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "093NSE-896608-01",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005559001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "093NER-896608-01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "89660801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF DC",
            "identifier": "9676-0039",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0123302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0442052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "769698",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Nicole Dixon, JD, PA-C
• Austin Dixon, DO
• Chekesha Dixon
• Desyree Allison Dixon, LCSW-C
• Ebonee Janae Dixon
• Janell Dixon
• Jasmine C Dixon
• Lashanta Renee Dixon, PMHNP-BC
• Lashea Dixon, LMSW
• Makenna Dixon

• Geriatric Medicine (Family Medicine) Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Geriatric Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.