Individual provider Active NPI

Kristin Rose Dixom, LPN

  • Licensed Practical Nurse
  • Beckley, WV
National Provider Identifier
1487565628
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
36079 Issued in WV
Practice address
788 Circleview Dr
Beckley, WV 25801-8408
Phone
(304) 923-7547
NPI assigned
Sep 16, 2026
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 36079 WV Primary

Addresses

Primary practice location

788 Circleview Dr
Beckley, WV 25801-8408

Mailing address

601 Venture Dr Ste 200
Morgantown, WV 26508-7310

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

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1487565628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 VENTURE DR STE 200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265087310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 CIRCLEVIEW DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018408",
            "telephone_number": "304-923-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXOM",
        "first_name": "KRISTIN",
        "middle_name": "ROSE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "36079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.