Dixie H Dodge PHD PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1171 Issued in CO

Legal business name

DIXIE H DODGE PHD PC

Practice address

219 East St Vrain
Colorado Springs, CO 80903

Phone

(719) 636-2669

Fax

(719) 577-9656

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dixie H Dodge, PHD PSYCHOLOGY

Title

President

Phone

(719) 636-2669

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Dixie H Dodge PhD Doing business as

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1437285897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 EAST ST VRAIN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-636-2669",
            "fax_number": "719-577-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 EAST ST VRAIN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-636-2669",
            "fax_number": "719-577-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE H DODGE PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "DIXIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-636-2669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CO",
            "license": "1171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICADE",
            "identifier": "034211",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "80206",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "35197",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10412365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dixie H Dodge PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anna Dixon, PT, DPT
• Joel Dixon, P.T.
• Kedisha A Dixon, LCSW
• Kimberly Dixon
• Mia Dixon

• Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.