Sandria R Nixon, DR. FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001771A Issued in IN

Practice address

211 N Eddy St.
South Bend, IN 46617-3096

Phone

(574) 237-9331

Fax

(574) 237-9252

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: sandria.nixon.1@23284.direct.athenahealth.com

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1104817733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "484-346-1692",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173096",
            "telephone_number": "574-237-9331",
            "fax_number": "574-237-9252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5838 W Brick Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466288420",
            "country_code": "US",
            "telephone_number": "574-247-1911",
            "fax_number": "574-247-1912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2725 Airview Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490021804",
            "country_code": "US",
            "telephone_number": "269-349-8386",
            "fax_number": "269-349-8397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIXON",
        "first_name": "SANDRIA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "DR. FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704141786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001771A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001771A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Dinsmoor Nightingale, MD
• Barbara B Niklinska, MD
• Randy Nims, MA
• Sheri A Nisely Frazier, MSW LCSW ACSW
• Michael Nivens, BA
• Nick Njuguna
• Rachel Njuguna, PHD
• Nocera Enterprises, LLC
• Ruth A Noeldner
• Samuel Nolan

• Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.