Individual provider Active NPI

Brenda M. Dixon

  • Counselor
  • Fayetteville, NC
National Provider Identifier
1679653588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
5295 Issued in NC
Practice address
1540 Purdue Dr Ste 200
Fayetteville, NC 28303-5510
Phone
(910) 867-8889
Fax
(910) 487-3061
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 5295 NC Primary

Addresses

Primary practice location

1540 Purdue Dr Ste 200
Fayetteville, NC 28303-5510

Mailing address

1442 Glanis Dr
Fayetteville, NC 28304-0319
Phone (910) 384-2798

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

LicenseStateTypeSpecialty
5295NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679653588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 GLANIS DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040319",
            "telephone_number": "910-384-2798",
            "fax_number": "910-487-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 PURDUE DR STE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035510",
            "telephone_number": "910-867-8889",
            "fax_number": "910-487-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "BRENDA",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "5295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.