Individual provider Active NPI

Tawana Nichole Nix, D.O.

  • Family Medicine Physician
  • Fall River Mills, CA
National Provider Identifier
1649324294
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9774 Issued in CA
Practice address
43563 1/2 Hwy 299
Fall River Mills, CA 96028
Phone
(530) 246-5910
Fax
(530) 357-2862
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9774 CA Primary

Addresses

Primary practice location

43563 1/2 Hwy 299
Fall River Mills, CA 96028

Mailing address

PO Box 490
Fall River Mills, CA 96028-0490
Phone (530) 336-6535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100907000793 CA Practitioner - Family Practice 0749304152 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9774CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayers Memorial Hospital District CurrentSince Nov 5, 2017 Accepting new patients
PHC-Fort Morgan Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Pit River Health Service, Inc. Past Accepting new patients
Mayers Memorial Hospital District Past Accepting new patients

Locations

43563 State Highway 299 E
Fl River Mls, CA 96028
Phone (530) 336-5511

Organizations & group practices 5

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1649324294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "960280490",
            "telephone_number": "530-336-6535",
            "fax_number": "530-294-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43563 1/2 HWY 299",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "96028",
            "telephone_number": "530-246-5910",
            "fax_number": "530-357-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "TAWANA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River Mills, CA

Sources for this page

Verify at the official NPI Registry.