Nix Direct Access Pediatrics PC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

NIX DIRECT ACCESS PEDIATRICS PC

Practice address

10274 Lake Arbor Way Ste 201
Mitchellville, MD 20721-3146

Phone

(301) 823-5999

Fax

(301) 823-5990

NPI assigned

May 27, 2022

Organization subpart

No

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

Authorized official

Name

Kijana N Nix, MDNPI 1043368756

Title

Ceo

Phone

(301) 823-5999

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kijana Nicola Nix, MD,FAAP

  • Pediatrics Physician
  • Hinesville, GA
  • NPI 1043368756

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1720727753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10274 LAKE ARBOR WAY STE 201",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213146",
            "telephone_number": "301-823-5999",
            "fax_number": "301-823-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10274 LAKE ARBOR WAY STE 201",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213146",
            "telephone_number": "301-823-5999",
            "fax_number": "301-823-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIX DIRECT ACCESS PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2024-08-02",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "NIX",
        "authorized_official_first_name": "KIJANA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-823-5999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319072200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043368756",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance Nchinda, HHA
• Kaiya Neal
• Marie Nestor, SOCIAL WORKER
• Victor T Nguyen
• Milton Nichols
• Adaeze Ashley Nnabue, OD
• Alexander Chukwuemeka Nnabue, O.D
• Norman G. McKoy MD & Associates PA
• Anna K Nowaczyk, SLP
• O.a.O Therapy and Consulting, LLC

• Pediatric Adolescent Medicine Physician in Mitchellville, MD
• Providers in Mitchellville, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.