Radiah Davina Adar Nixon, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11022325 Issued in FL

Practice address

1130 Hickory St Ste B
Melbourne, FL 32901-1973

Phone

(321) 434-7676

Fax

(321) 952-6179

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: radiah.nixon@532070890209284.direct.elationemr.com

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1467177626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 LARCH CIR NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329056300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HICKORY ST STE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011973",
            "telephone_number": "321-434-7676",
            "fax_number": "321-952-6179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8725 N Wickham Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329402240",
            "country_code": "US",
            "telephone_number": "321-434-7676",
            "fax_number": "321-952-6179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1264 Malabar Rd SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329072556",
            "country_code": "US",
            "telephone_number": "321-434-7676",
            "fax_number": "321-952-6179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "490 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327962871",
            "country_code": "US",
            "telephone_number": "321-434-7676",
            "fax_number": "321-952-6179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIXON",
        "first_name": "RADIAH",
        "middle_name": "DAVINA ADAR",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11022325",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11022325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115824700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.