Active NPI
William Russell Nixon Jr., PH.D.
- Psychoanalysis Psychologist
- Birmingham, MI
National Provider Identifier
1568621571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalysis Psychologist
- License
- 002567
- Practice address
- 300 E Maple Rd
Suite 323
Birmingham, MI 48009-6308 - Phone
- (248) 644-7368
- Fax
- (248) 644-2901
- NPI assigned
- Jun 4, 2008
- Last updated
- Jun 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalysis Psychologist | 103TP0814X | 002567 | MI | Primary |
Addresses
Primary practice location
300 E Maple Rd
Suite 323
Birmingham, MI 48009-6308
Mailing address
300 E Maple Rd
Suite 323
Birmingham, MI 48009-6308
Phone (248) 644-7368
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0N60160 | Other | MI | MEDICARE PROVIDER NUMBER |
| 0N60160 | Other | MP | MEDICARE PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002567 | MI | MD | Psychoanalysis Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1568621571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MAPLE RD",
"address_2": "SUITE 323",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480096308",
"telephone_number": "248-644-7368",
"fax_number": "248-644-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E MAPLE RD",
"address_2": "SUITE 323",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480096308",
"telephone_number": "248-644-7368",
"fax_number": "248-644-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIXON",
"first_name": "WILLIAM",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-04",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "MI",
"license": "002567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "0N60160",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "0N60160",
"state": "MP"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.