Individual provider Active NPI

Michael Aron Dixon, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ambridge, PA
National Provider Identifier
1104478668
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP020619 Issued in PA
Practice address
1098 Kennedy Dr
Ambridge, PA 15003-2314
Phone
(724) 385-0588
NPI assigned
Jul 15, 2019
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP020619 PA Primary

Addresses

Primary practice location

1098 Kennedy Dr
Ambridge, PA 15003-2314

Mailing address

1098 Kennedy Dr
Ambridge, PA 15003-2314
Phone (724) 385-0588

Other practice location 1

130 W North St
New Castle, PA 16101-3906
Phone (724) 658-3578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20201015000995 PA Order and Referring Only - PsychiatryPractitioner - Psychiatry 4486074325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP020619PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver County Pathways LLC CurrentSince May 10, 2020 Accepting new patients
Human Services Center Past Accepting new patients

Locations

1098 Kennedy Dr
Ambridge, PA 15003
Phone (724) 385-0588

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1104478668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 KENNEDY DR",
            "city": "AMBRIDGE",
            "state": "PA",
            "postal_code": "150032314",
            "telephone_number": "724-385-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 KENNEDY DR",
            "city": "AMBRIDGE",
            "state": "PA",
            "postal_code": "150032314",
            "telephone_number": "724-385-0588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W North St",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "PA",
            "postal_code": "161013906",
            "country_code": "US",
            "telephone_number": "724-658-3578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "MICHAEL",
        "middle_name": "ARON",
        "name_prefix": "Dr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP020619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambridge, PA

Sources for this page

Verify at the official NPI Registry.