Individual provider Active NPI

Terrie B. Dixon, PA-C

  • Physician Assistant
  • East Point, GA
National Provider Identifier
1336214303
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004823 Issued in GA
Practice address
1422 Cleveland Ave
East Point, GA 30344-6983
Phone
(404) 766-3337
Fax
(404) 766-1464
NPI assigned
Nov 22, 2006
Last updated
Jun 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004823 GA Primary

Addresses

Primary practice location

1422 Cleveland Ave
East Point, GA 30344-6983

Mailing address

1422 Cleveland Ave
East Point, GA 30344-6983
Phone (404) 766-3337

Other identifiers 1

IdentifierTypeStateIssuer
748138987AMedicaidGA

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

LicenseStateTypeSpecialty
004823GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Pediatric & Adolescent Group, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13568/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1336214303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303446983",
            "telephone_number": "404-766-3337",
            "fax_number": "404-766-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303446983",
            "telephone_number": "404-766-3337",
            "fax_number": "404-766-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "TERRIE",
        "middle_name": "B.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748138987A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.