Detra K Dixon, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP213793 Issued in GA

Practice address

227 Amalie Dr
Macon, GA 31220-2667

Phone

(478) 731-9521

NPI assigned

Jun 5, 2019

Last updated

Oct 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649

  Single Specialty

  Medicare reassignment NPD
• Medplus Immediate Care

  • General Practice Physician
  • Macon, GA
  • NPI 1215600564

  Single Specialty

  Medicare reassignment NPD
• Crisp Regional Hospital, Inc

  dba Crisp Regional LTC Pharmacy

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1376101196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 AMALIE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312202667",
            "telephone_number": "478-731-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 AMALIE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312202667",
            "telephone_number": "478-731-9521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153270",
            "country_code": "US",
            "telephone_number": "229-276-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "DETRA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP213793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSING NUMBER",
            "identifier": "RN213793",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "detra_kerr@yahoo.com",
            "affiliation": "N",
            "address_1": "227 Amalie Dr",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312202667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Dipaolo
• Discovering Solutions Inc
• Jesse Mark Divakar, DPT
• Joni Reba Dixon-Milner, PNP
• Damon C. Dixon, MD
• Evelyn Dixon, M.S.CCC-SLP
• Isadora Dixon, LCSW-C
• Jennifer Jackson Dixon, DMD
• Kenyon Kenyatta Dixon, LPC
• Kersten Marie Dixon

• Family Nurse Practitioner in Macon, GA
• Providers in Macon, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.