Dixie a. Fullerton

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

DIXIE A. FULLERTON

Doing business as

Carefree Footwear

Practice address

1618 E Charleston Blvd
Las Vegas, NV 89104-1826

Phone

(702) 384-5121

Fax

(702) 384-4416

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Dixie A Fullerton

Title

Owner

Phone

(702) 384-5121

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carefree Footwear Doing business as

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1336296979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041826",
            "telephone_number": "702-384-5121",
            "fax_number": "702-384-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041826",
            "telephone_number": "702-384-5121",
            "fax_number": "702-384-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE A. FULLERTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "FULLERTON",
        "authorized_official_first_name": "DIXIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-384-5121",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003302425",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carefree Footwear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosalie Diwa
• Taylor Hallon Diwelgama, PHARMD
• Asia Anna Dix
• Christy Dix, MA, CPC-I,
• Richard Michael Dix, M.D., J.D.
• Dixie a. Fullerton (Superior Limb & Brace Company)
• Joyce Dixione
• Shanker N Dixit, M.D.
• Tanisha Dixon Ford
• Taylor Dixon-Myers

• Prosthetic/Orthotic Supplier in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Prosthetic/Orthotic Supplier in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.