Active NPI
Isadora Dixon, LCSW-C
- Clinical Social Worker
- Macon, GA
National Provider Identifier
1154709194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20755
- Practice address
- 6300 Moseley Dixon Rd
201P
Macon, GA 31220-8400 - Phone
- (410) 900-0905
- NPI assigned
- May 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20755 | MD | Primary |
Addresses
Primary practice location
6300 Moseley Dixon Rd
201P
Macon, GA 31220-8400
Mailing address
6300 Moseley Dixon Rd
201P
Macon, GA 31220-8400
Phone (410) 900-0905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20755 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431302400000",
"number": "1154709194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 MOSELEY DIXON RD",
"address_2": "201P",
"city": "MACON",
"state": "GA",
"postal_code": "312208400",
"telephone_number": "410-900-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 MOSELEY DIXON RD",
"address_2": "201P",
"city": "MACON",
"state": "GA",
"postal_code": "312208400",
"telephone_number": "410-900-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "ISADORA",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-11",
"last_updated": "2015-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "20755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.