Samuel Ervin Dixon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2479 Issued in CA

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(808) 433-4857

Fax

(808) 433-4857

NPI assigned

Jan 17, 2006

Last updated

Jul 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• East Valley Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1164414447
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1245219310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "I JARRETT WHITE ROAD",
            "address_2": "TAMC",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968597747",
            "telephone_number": "808-433-4857",
            "fax_number": "808-433-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-4857",
            "fax_number": "808-433-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "SAMUEL",
        "middle_name": "ERVIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "2479",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "HI",
            "license": "APRN907",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carroll J. Diebold, M.D.
• Frank Dimarco, OTD
• Andrew Louis Dimatteo, MD
• Timothy Ba Dinh, D.O.
• Kathlyn Dino
• Annette K. Dodd, LCSW
• Lauren Churchill Doerfler, MD
• Jennifer Domingo, MD
• Edward Donnarumma, SOCIAL WORKER
• Ryan Doran, RDN

• Certified Registered Nurse Anesthetist in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Certified Registered Nurse Anesthetist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.