Individual provider Active NPI

Paula Le'Shae Dixon, FNP-BC

  • Family Nurse Practitioner
  • Kannapolis, NC
National Provider Identifier
1336491885
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005829 Issued in NC
Practice address
707 S Main St
Kannapolis, NC 28081-4915
Phone
(704) 925-8724
Fax
(704) 925-8727
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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 5005829 NC Primary

Addresses

Primary practice location

707 S Main St
Kannapolis, NC 28081-4915

Mailing address

707 S Main St
Kannapolis, NC 28081-4915
Phone (704) 925-8724

Other practice location 1

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130109000414 NC Practitioner - Nurse Practitioner 8022261775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

707 S Main St
Kannapolis, NC 28081-4915
Phone (704) 925-8724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5005829NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Health Services LLC Family CurrentSince Jul 14, 2019 Accepting new patients

Locations

707 S Main St
Kannapolis, NC 28081
Phone (704) 925-8724

Interoperability endpoints

  • Direct secure messaging: paula.dixon.1@19828.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19828/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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1336491885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S MAIN ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814915",
            "telephone_number": "704-925-8724",
            "fax_number": "704-925-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S MAIN ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814915",
            "telephone_number": "704-925-8724",
            "fax_number": "704-925-8727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1070 Vinehaven Dr NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252438",
            "country_code": "US",
            "telephone_number": "704-783-1840",
            "fax_number": "704-783-1850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "PAULA",
        "middle_name": "LE'SHAE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

Verify at the official NPI Registry.