Dixon Mwose

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

License

201371060-A Issued in IN

Practice address

2610 E Jefferson Blvd
South Bend, IN 46615-2724

Phone

(574) 276-5026

Fax

(574) 251-0869

NPI assigned

Nov 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1598474652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-276-5026",
            "fax_number": "574-251-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-276-5026",
            "fax_number": "574-251-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWOSE",
        "first_name": "DIXON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "IN",
            "license": "201371060-A",
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "IN",
            "license": "201371060-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-3518606",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201371060A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ngina Muthusi
• Natasha Teretha Mwale
• Teresiah W. Mwangi-Riley
• Andrew Mwangi
• Bancy Mwangi, FNP-BC
• Delayna Myers, RD,LD
• George Myers, DPT
• Susan D Myers, LCSW
• Victoria Myers
• Myeyedr Optometry of Indiana, LLC

• Day Training/Habilitation Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Day Training/Habilitation Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.