Active NPI
Matthew Joseph Dixon
- Behavior Technician
- Killeen, TX
National Provider Identifier
1447084546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1143922
- Practice address
- 3000 Illinois Ave
Killeen, TX 76543-5371 - Phone
- (254) 402-4800
- NPI assigned
- Aug 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB1143922 | WA | Primary |
Addresses
Primary practice location
3000 Illinois Ave
Killeen, TX 76543-5371
Mailing address
12000 129TH LN NE Apt P203
Kirkland, WA 98034-8639
Phone (616) 690-0422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1143922 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1447084546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12000 129TH LN NE APT P203",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980348639",
"telephone_number": "616-690-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 ILLINOIS AVE",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765435371",
"telephone_number": "254-402-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "MATTHEW",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-29",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "BACB1143922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.