Individual provider Active NPI

Jo-Ann Dixon

  • Professional Counselor
  • Conyers, GA
National Provider Identifier
1124502802
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
005375 Issued in GA
Practice address
863 Flat Shoals Rd SE Ste 134
Conyers, GA 30094-6633
Phone
(678) 270-7460
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 005375 GA Primary

Addresses

Primary practice location

863 Flat Shoals Rd SE Ste 134
Conyers, GA 30094-6633

Mailing address

863 Flat Shoals Rd SE Ste 134
Conyers, GA 30094-6633
Phone (678) 270-7460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930001445 GA Practitioner - Mental Health Counselor 9032640289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005375GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
On Eagle'S Wings Counseling Center CurrentSince Mar 31, 2024 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Jul 5, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

863 Flat Shoals Rd SE
Ste 134
Conyers, GA 30094
Phone (470) 708-8793

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1124502802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 FLAT SHOALS RD SE STE 134",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946633",
            "telephone_number": "678-270-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 FLAT SHOALS RD SE STE 134",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946633",
            "telephone_number": "678-270-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "JO-ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "005375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.