Active NPI
Marilyn R Nixon, LPN
- Licensed Practical Nurse
- Concord, NC
National Provider Identifier
1659856409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 78008
- Practice address
- 284 Executive Park Dr Ste 100
Concord, NC 28025-1833 - Phone
- (704) 939-1100
- NPI assigned
- Sep 27, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 78008 | NC | Primary |
Addresses
Primary practice location
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
Other practice location 1
Marilyn Nixon
500 East Village Drive
monroe, NC 28112
Phone (704) 635-2080
Other names 1
- Marilyn R Nixon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78008 | NC | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1659856409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100"
}
],
"practiceLocations": [
{
"address_1": "MARILYN NIXON",
"address_2": "500 EAST VILLAGE DRIVE",
"address_purpose": "LOCATION",
"city": "monroe",
"state": "NC",
"postal_code": "28112",
"country_code": "US",
"telephone_number": "704-635-2080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIXON",
"first_name": "MARILYN",
"middle_name": "R",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-27",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NC",
"license": "78008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARILYN",
"last_name": "NIXON",
"middle_name": "R",
"credential": "LPN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.