Individual provider Active NPI

Shamieka Virella Dixon, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1669639522
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2012-00913 Issued in NC
Practice address
3541 Randolph Rd
Ste 206
Charlotte, NC 28211-1082
Phone
(704) 381-8336
NPI assigned
May 19, 2008
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2012-00913 NC Primary
Pediatric Adolescent Medicine Physician 2080A0000X 2012-00913 NC

Addresses

Primary practice location

3541 Randolph Rd
Ste 206
Charlotte, NC 28211-1082

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

231 S Sharon Amity Rd
Charlotte, NC 28211-2803
Phone (704) 304-6400

Other practice location 2

3193 W Highway 74
Monroe, NC 28110-8437
Phone (704) 698-4089

Other practice location 3

3541 Randolph Rd
Ste 210
Charlotte, NC 28211-1082
Phone (704) 381-8336

Other practice location 4

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1422

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sdixon60245@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120911000246 NC Practitioner - Pediatric Medicine 6507038544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 10, 2014 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 10, 2014 Accepting new patients
Carolinas Medical Center Adolescent Medicine CurrentSince Sep 1, 2012 Accepting new patients
Carolinas Medical Center CurrentSince Sep 1, 2012 Accepting new patients
Carolinas Medical Center Pediatrics Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

3541 Randolph Rd
Ste 206
Charlotte, NC 28211
Phone (704) 381-8336

3541 Randolph Rd
Ste 210
Charlotte, NC 28211
Phone (704) 381-8336

3193 W Highway 74
Monroe, NC 28110
Phone (704) 689-4089

Interoperability endpoints

  • Direct secure messaging: sdixon60245@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1669639522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 RANDOLPH RD",
            "address_2": "STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111082",
            "telephone_number": "704-381-8336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 S Sharon Amity Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112803",
            "country_code": "US",
            "telephone_number": "704-304-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3193 W Highway 74",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281108437",
            "country_code": "US",
            "telephone_number": "704-698-4089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3541 Randolph Rd",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111082",
            "country_code": "US",
            "telephone_number": "704-381-8336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "SHAMIEKA",
        "middle_name": "VIRELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2012-00913",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NC",
            "license": "2012-00913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdixon60245@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "3541 Randolph Rd",
            "address_2": "Ste 206",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282111082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.