Kimberly W Dixon, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

638 Issued in SC

Practice address

404 Blue Elderberry Run
Moncks Corner, SC 29461-2908

Phone

(843) 425-2805

NPI assigned

Jul 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Impact Therapy, LLC

  • Physical Therapist
  • Mount Pleasant, SC
  • NPI 1336325984
  NPD (past)
• Pearl Rehabilitation LLC

  • Physical Therapy Assistant
  • N Charleston, SC
  • NPI 1962635656
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1720333040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BLUE ELDERBERRY RUN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612908",
            "telephone_number": "843-425-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BLUE ELDERBERRY RUN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612908",
            "telephone_number": "843-425-2805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Curing Ct",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "294619419",
            "country_code": "US",
            "telephone_number": "843-761-2791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "KIMBERLY",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "SC",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McGregor T. Dennis Jr., D.M.D.
• Rebecca Denny
• Dental Professionals of South Carolina, P.C. (Dental Care at Foxbank)
• Yvonne Dingle-Rogers
• Delissa L Dixon, MSW
• Stacie Marie Dizzley-Streeter
• Tiffany S Doctor, LMSW
• Doctors Care SC, PA (Doctors Care Moncks Corner)
• Donald S. Kilpatrick, M.D.,P.a.
• Brooke Mellady Dooley

• Physical Rehabilitation Occupational Therapist in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Physical Rehabilitation Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.