Active NPI
Deborah Lea Fowler Dixon Bross, MD
- Family Medicine Physician
- Troy, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036901572
- Practice address
- 301 Edwardsville Road
Troy, IL 62294 - Phone
- (618) 667-7057
- Fax
- (618) 667-8131
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 036091572 | IL | |
| Family Medicine Physician | 207Q00000X | 036901572 | IL | Primary |
Addresses
Primary practice location
301 Edwardsville Road
Troy, IL 62294
Mailing address
301 Edwardsville Road
Troy, IL 62294
Phone (618) 667-7057
Other practice location 1
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240
Other practice location 2
2 Memorial Dr Ste 220
Alton, IL 62002-6723
Phone (618) 433-7901
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036091572 | Medicaid | IL |
Other names 1
- Deborah Lea Fowler-Dixon
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036901572 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Current | Accepting new patients | |
| Fairview Heights Medical Group SC | Current | Accepting new patients | |
| Anderson Medical Group, LLC | Family Medicine | Past | Accepting new patients |
Locations
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
2 Memorial Dr
Ste 220
Alton, IL 62002
Phone (618) 462-6200
660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433
Interoperability endpoints
- dbross1345044@direct.carenet.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba BJC Medical Group of Illinois
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1073022000
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Alton, IL
- NPI 1548278476
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1639186760
-
dba Christian Hospital
- Ambulance
- Saint Louis, MO
- NPI 1073769329
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735948800000",
"number": "1487692430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 EDWARDSVILLE ROAD",
"city": "TROY",
"state": "IL",
"postal_code": "62294",
"telephone_number": "618-667-7057",
"fax_number": "618-667-8131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 EDWARDSVILLE ROAD",
"city": "TROY",
"state": "IL",
"postal_code": "62294",
"telephone_number": "618-667-7057",
"fax_number": "618-667-8131"
}
],
"practiceLocations": [
{
"address_1": "1 Memorial Dr",
"address_purpose": "LOCATION",
"city": "Alton",
"state": "IL",
"postal_code": "620026722",
"country_code": "US",
"telephone_number": "618-463-7240",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Memorial Dr Ste 220",
"address_purpose": "LOCATION",
"city": "Alton",
"state": "IL",
"postal_code": "620026723",
"country_code": "US",
"telephone_number": "618-433-7901",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROSS",
"first_name": "DEBORAH",
"middle_name": "LEA FOWLER DIXON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-03",
"last_updated": "2025-01-04",
"certification_date": "2025-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036091572",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036901572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036091572",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Memorial Dr",
"city": "Alton",
"state": "IL",
"country_code": "US",
"postal_code": "620026722",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "FOWLER-DIXON",
"middle_name": "LEA",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Troy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.