Individual provider Active NPI

Jessie Marie Dixon, FNP-BC

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1225890536
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26870 Issued in SC
Practice address
3205 Freedom Dr Ste 8500
Charlotte, NC 28208-3491
Phone
(803) 374-0527
NPI assigned
Jan 23, 2024
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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 26870 SC Primary

Addresses

Primary practice location

3205 Freedom Dr Ste 8500
Charlotte, NC 28208-3491

Mailing address

PO Box 39488
Charlotte, NC 28278-1026
Phone (803) 374-0527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20241101000209 SC Practitioner - Nurse Practitioner 7517490329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PH Health Care Services IncGroup PAC ID 2163683012, 13 clinicians

Practice addresses (Care Compare)

4741 Hwy 153
Suite B
Easley, SC 29642-9161
Phone 8648872600918414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26870SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PH Health Care Services Inc CurrentSince Aug 9, 2024 Accepting new patients
PH Healthcare Services, Inc. CurrentSince Aug 9, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1225890536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39488",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282781026",
            "telephone_number": "803-374-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 FREEDOM DR STE 8500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083491",
            "telephone_number": "803-374-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "JESSIE",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.