Individual provider Active NPI

Candida R Dixon, APRN

  • Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1104489186
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3013306 Issued in KY
Practice address
101 Town and Country LN Ste 100
Hazard, KY 41701-9524
Phone
(606) 439-1300
Fax
(606) 439-1400
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3013306 KY Primary

Addresses

Primary practice location

101 Town and Country LN Ste 100
Hazard, KY 41701-9524

Mailing address

PO Box 1988
Hazard, KY 41702-1988
Phone (606) 435-7642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190517000650 KY Practitioner - Nurse Practitioner 2264775022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Centers of Eastern Kentucky LLCGroup PAC ID 3971415993, 46 clinicians

Practice addresses (Care Compare)

425 Hindman Byp
Hindman, KY 41822-8666
Phone (606) 785-1300

Hospital & facility affiliations

  • Hazard Arh Regional Medical Center Hospital, Hazard, KY, CCN 180029
  • Harlan Arh Hospital Hospital, Harlan, KY, CCN 180050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince May 1, 2019 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince May 1, 2019 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Past Accepting new patients

Locations

145 Citizens Ln
Ste B
Hazard, KY 41701
Phone (606) 439-1300

101 Town and Country Ln
#100
Hazard, KY 41701
Phone (606) 439-1300

101 Town and Country Ln
Hazard, KY 41701
Phone (606) 435-0460

425 Hindman Byp
Hindman, KY 41822
Phone (606) 785-1300

21992 Main St
Hyden, KY 41749
Phone (606) 672-5200

47 Highway 119 S
Ste 3
Whitesburg, KY 41858
Phone (606) 403-0001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCJFBA

Organizations & group practices 6

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 3

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1104489186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1988",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417021988",
            "telephone_number": "606-435-7642",
            "fax_number": "606-436-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWN AND COUNTRY LN STE 100",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019524",
            "telephone_number": "606-439-1300",
            "fax_number": "606-439-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "CANDIDA",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.