Individual provider Active NPI

Samiyra Shabazz-Dixon, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1518547744
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
257417 Issued in KY
Practice address
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone
(859) 253-1686
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257417 KY Primary

Addresses

Primary practice location

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Mailing address

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone (859) 253-1686

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL hopehill.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221002861 KY Practitioner - Clinical Social Worker 1658741319 Reassigns benefits to 4 organizations
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
New Vista of the Bluegrass Inc Current Accepting new patients
New Vista of the Bluegrass Inc CurrentSince Jan 23, 2023 Accepting new patients
New Vista of the Bluegrass CurrentSince Jan 23, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Dec 24, 2024 Accepting new patients
1St Priority Healthcare LLC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1351 Newtown Pike
Bldg 5
Lexington, KY 40511
Phone (859) 233-0444

1351 Newtown Pike
Bldg 1
Lexington, KY 40511
Phone (858) 253-1686

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

312 S 4th St
Louisville, KY 40202
Phone (502) 213-5590

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1518547744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ-DIXON",
        "first_name": "SAMIYRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hopehill.org",
            "affiliation": "N",
            "address_1": "529 Maysville Rd",
            "city": "MT Sterling",
            "state": "KY",
            "country_code": "US",
            "postal_code": "403539336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.