Individual provider Active NPI

Lerome Dixon

  • In Home Supportive Care Agency
  • Round Rock, TX
National Provider Identifier
1710411996
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
80-0417468 Issued in TX
Practice address
402 W Palm Valley Blvd Ste a
Round Rock, TX 78664-4200
Phone
(512) 373-2353
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 80-04174687 TX
In Home Supportive Care Agency 253Z00000X 80-0417468 TX Primary

Addresses

Primary practice location

402 W Palm Valley Blvd Ste a
Round Rock, TX 78664-4200

Mailing address

402 W Palm Valley Blvd Ste 243
Round Rock, TX 78664-4200
Phone (512) 373-2353

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

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710411996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W PALM VALLEY BLVD STE 243",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644200",
            "telephone_number": "512-373-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PALM VALLEY BLVD STE A",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644200",
            "telephone_number": "512-373-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "LEROME",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "TX",
            "license": "80-04174687",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "80-0417468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.