Individual provider Active NPI

Jessica Tara Dixon-Neal, LPC

  • Professional Counselor
  • Porter, OK
National Provider Identifier
1124697511
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10393 Issued in OK
Practice address
505 S Main St
Porter, OK 74454-1015
Phone
(918) 483-0111
NPI assigned
Jun 21, 2021
Last updated
Jun 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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 10393 OK Primary

Addresses

Primary practice location

505 S Main St
Porter, OK 74454-1015

Mailing address

1450 Stone Crest Dr
Edmond, OK 73034-6605
Phone (918) 734-7797

Other practice location 1

607 S Broadway
Coweta, OK 74429-5000
Phone (918) 486-5564

Other names 1

  • Jessica Dixon-Neal Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240404002701 OK Practitioner - Mental Health Counselor 9032557475 Reassigns benefits to 2 organizations
Practice locations: Tulsa, OK

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 N 32ND St
Muskogee, OK 74401-2104
Phone (918) 912-2333

PO Box
Suite 334
Porter, OK 74454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10393OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Verdigris Valley Health Centers, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Arkansas Verdigris Valley Health Centers, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Soaak Clinics LLC CurrentSince Feb 1, 2025 Accepting new patients
Cardiovascular Surgical Specialists Corp Past Accepting new patients

Locations

607 S Broadway
Coweta, OK 74429
Phone (918) 279-6675

505 S Main St
Tullahassee, OK 74454
Phone (918) 483-0111

2448 E 81st St
Ste 5100
Tulsa, OK 74137
Phone (918) 584-2500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13866/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jessica.dixon-neal.1@25507.direct.athenahealth.com

Organizations & group practices 4

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1124697511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 STONE CREST DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346605",
            "telephone_number": "918-734-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "city": "PORTER",
            "state": "OK",
            "postal_code": "744541015",
            "telephone_number": "918-483-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Coweta",
            "state": "OK",
            "postal_code": "744295000",
            "country_code": "US",
            "telephone_number": "918-486-5564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON-NEAL",
        "first_name": "JESSICA",
        "middle_name": "TARA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "10393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DIXON-NEAL",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Porter, OK

Sources for this page

Verify at the official NPI Registry.