Individual provider Active NPI

Kaycee Nicole Dixon, FNP-C

  • Family Nurse Practitioner
  • Kodak, TN
National Provider Identifier
1154885531
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25418 Issued in TN
Practice address
2946 Winfield Dunn Pkwy Ste 107
Kodak, TN 37764-4316
Phone
(865) 933-9950
NPI assigned
Jan 30, 2019
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25418 TN Primary

Addresses

Primary practice location

2946 Winfield Dunn Pkwy Ste 107
Kodak, TN 37764-4316

Mailing address

2945 Riley Dr
Kodak, TN 37764-1623
Phone (865) 805-0612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190618002452 TN Practitioner - Nurse Practitioner 9931433323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jandj Medical PLLCGroup PAC ID 5991169989, 2 clinicians
Tennessee Spine Wellness and Medical Group LLCGroup PAC ID 2961831623, 4 clinicians

Practice addresses (Care Compare)

208 Prince St
Sevierville, TN 37862-3821
Phone (865) 774-7481

470 Collier Dr
Sevierville, TN 37862-6931
Phone (865) 286-5421

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25418TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Medical Services PLLC Family CurrentSince Aug 5, 2019 Accepting new patients
All Care Family Practice Inc Family CurrentSince Aug 1, 2025 Accepting new patients
J&J Medical PLLC Family CurrentSince Aug 1, 2025 Accepting new patients

Locations

2946 Winfield Dunn Pkwy
Kodak, TN 37764
Phone (865) 465-3936

2946 Winfield Dunn Pkwy
Ste 107
Kodak, TN 37764
Phone (865) 465-3936

208 Prince St
Sevierville, TN 37862
Phone (865) 774-7481

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.

Hospital & facility affiliations 1

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1154885531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 RILEY DR",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377641623",
            "telephone_number": "865-805-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 WINFIELD DUNN PKWY STE 107",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377644316",
            "telephone_number": "865-933-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "KAYCEE",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodak, TN

Sources for this page

Verify at the official NPI Registry.