Individual provider Active NPI

Lester Jonathan Dixon, MD

  • Emergency Medicine Physician
  • Redmond, OR
National Provider Identifier
1609803865
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD24053 Issued in OR
Practice address
1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone
(541) 548-8131
Fax
(541) 526-6608
NPI assigned
Jun 26, 2006
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD24053 OR Primary

Addresses

Primary practice location

1253 NW Canal Blvd
Redmond, OR 97756-1334

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 1

IdentifierTypeStateIssuer
181980MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldixon18289@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214000698 OR Practitioner - Emergency Medicine 4183681851 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Apr 1, 2010 Accepting new patients
St. Charles Health System, Inc. CurrentSince Oct 12, 2014 Accepting new patients
St. Charles Health System, Inc. CurrentSince Apr 1, 2010 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine CurrentSince Oct 12, 2014 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine Current Accepting new patients
Tacoma Emergency Medicine Associates PC Emergency Medicine Past Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

480 NE A St
Madras, OR 97741
Phone (541) 475-4800

1201 NE Elm St
Prineville, OR 97754
Phone (503) 447-6254

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1609803865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-526-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "LESTER",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD24053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181980",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldixon18289@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "1253 NW Canal Blvd",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.