NPIMap

Individual provider Active NPI

William M Dixon III, MD

  • Family Medicine Physician
  • Prosperity, SC
National Provider Identifier
1710964416
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22715 Issued in SC
Practice address
600 N Wheeler Ave
Prosperity, SC 29127
Phone
(803) 364-4852
Fax
(803) 364-2014
NPI assigned
Dec 23, 2005
Last updated
Oct 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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 22715 SC Primary

Addresses

Primary practice location

600 N Wheeler Ave
Prosperity, SC 29127

Mailing address

PO Box 630
Prosperity, SC 29127-0630
Phone (803) 364-4852

Other identifiers 3

IdentifierTypeStateIssuer
080175032OtherSCRAILROAD MEDICARE
T69896MedicaidSC
0434180OtherSCCIGNA

Other names 1

  • Chip Dixon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221000527 SC Practitioner - Family Practice 9234168162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lovelace Family Medicine PAGroup PAC ID 6002719655, 9 clinicians

Practice addresses (Care Compare)

600 N Wheeler Ave
Prosperity, SC 29127-9332
Phone (803) 364-4852

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Family Medicine, PA CurrentSince Sep 1, 2001 Accepting new patients
Newberry County Memorial Hospital Past Accepting new patients

Locations

600 N Wheeler Ave
Prosperity, SC 29127
Phone (803) 296-5879

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1710964416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "291270630",
            "telephone_number": "803-364-4852",
            "fax_number": "803-364-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WHEELER AVE",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "29127",
            "telephone_number": "803-364-4852",
            "fax_number": "803-364-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080175032",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T69896",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0434180",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIP",
            "last_name": "DIXON",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Prosperity, SC

Sources for this page

Verify at the official NPI Registry.