NPIMap

Organization Active NPI

Dixon Family Medical Center, LLC

  • Rural Health Clinic/Center
  • Washington, LA
National Provider Identifier
1366847337
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
AP05959 Issued in LA
Legal business name
DIXON FAMILY MEDICAL CENTER, LLC
Practice address
536 St. Landry Veterans Memorial Hwy.
Washington, LA 70589-4420
Phone
(337) 628-5014
Fax
(337) 826-5401
NPI assigned
Nov 3, 2014
Last updated
Sep 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Authorized official

Name
Monique Bianca Declouet-Dixon, FNP
Title
Family Nurse Practitioner
Phone
(337) 628-5014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X AP05959 LA Primary

Addresses

Primary practice location

536 St. Landry Veterans Memorial Hwy.
Washington, LA 70589-4420

Mailing address

PO Box 596
Washington, LA 70589-0596
Phone (337) 628-5014

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1366847337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "WASHINGTON",
            "state": "LA",
            "postal_code": "705890596",
            "telephone_number": "337-628-5014",
            "fax_number": "337-826-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 ST. LANDRY VETERANS MEMORIAL HWY.",
            "city": "WASHINGTON",
            "state": "LA",
            "postal_code": "705894420",
            "telephone_number": "337-628-5014",
            "fax_number": "337-826-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXON FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "DECLOUET-DIXON",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "BIANCA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "337-628-5014",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "AP05959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.