Ray Ashley Dixon, PHARMD
Individual provider Active NPI Pharmacist · Baxley, GA
NPI 1184657017 · NPPES record last updated Jul 8, 2007
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Oct 20, 2021.
Key facts
- NPI
- 1184657017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 21788 (GA)
- Practice address
- 34 NW Park Ave
Baxley, GA 31513-0049 - Phone
- (912) 367-2488
- Fax
- (912) 367-7235
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21788 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21788 | GA | Yes |
Addresses
Primary practice location
34 NW Park Ave
Baxley, GA 31513-0049
Mailing address
5857 Lanes Bridge Rd
Jesup, GA 31545-6503
Phone (912) 530-6813
Other providers in Baxley, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.