Kelly Patricia Dixon, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003504 Issued in OH

Practice address

2817 Reilly St
Fort Bragg, NC 28310-1144

Phone

(910) 692-2444

NPI assigned

Mar 19, 2020

Last updated

Oct 3, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1487280624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 BRAMBLE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283101144",
            "telephone_number": "910-692-2444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Winslow Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452061144",
            "country_code": "US",
            "telephone_number": "419-707-2542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "KELLY",
        "middle_name": "PATRICIA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT00003504",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT003504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riaz Jalal Dini, DMD
• Sandi L Distefano, CRNA
• John Thomas Distelhorst, DO, MPH, FACPM
• Ethan Dixon, RD
• Keisha Dixon
• Margaret Leah DO, RD
• Deidra Renee Dodd, BSN, DNP, FNP-C
• Michelle Anne Dodge, LCSW
• Jesse Aaron Dodson, PA
• Nina Doering, D.D.S

• Athletic Trainer in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.