Active NPI
Willie Nathaniel Dixon
- Assisted Living Facility
- Wilson, NC
National Provider Identifier
1063544096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- FCL-098-009
- Practice address
- 2817 Tilghman Rd N
Wilson, NC 27896-8908 - Phone
- (252) 243-9827
- Fax
- (252) 291-9448
- NPI assigned
- Mar 13, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | FCL-098-009 | NC | Primary |
Addresses
Primary practice location
2817 Tilghman Rd N
Wilson, NC 27896-8908
Mailing address
2817 Tilghman Rd N
Wilson, NC 27896-8908
Phone (252) 243-9827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7801424 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| FCL-098-009 | NC | MD | Assisted Living Facility |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willie N Dixon | Assisted Living Facility | Past | Accepting new patients |
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, 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": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1063544096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 TILGHMAN RD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278968908",
"telephone_number": "252-243-9827",
"fax_number": "252-291-9448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 TILGHMAN RD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278968908",
"telephone_number": "252-243-9827",
"fax_number": "252-291-9448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "WILLIE",
"middle_name": "NATHANIEL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NC",
"license": "FCL-098-009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7801424",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
- Dixon and Holmes DDS, PA
- Andre Dixon
- Destiny Dixon
- Forrest F Dixon, DDS
- Vickie La'Nell Dixon, CRC, LPC
- DLP Wilmed Nursing Care and Rehabilitation Center LLC (Wilson Rehabilitation and Nursing Center)
- DLP Wilson Medical Center LLC (Wilson Medical Center - Same Day Surgery)
- DLP Wilson Medical Center LLC (Wilson Medical Center)
- DLP Wilson Medical Center LLC (Wilson Medical Center Reference Lab)
- DLP Wilson Medical Center LLC (Wilson Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.