Active NPI
Dixie D Richards, MD
- Dermatology Physician
- Los Angeles, CA
National Provider Identifier
1740358464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G57309
- Practice address
- 11633 San Vicente Blvd
Suite 310
Los Angeles, CA 90049-6514 - Phone
- (310) 326-5949
- Fax
- (310) 326-6239
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G57309 | CA | Primary |
Addresses
Primary practice location
11633 San Vicente Blvd
Suite 310
Los Angeles, CA 90049-6514
Mailing address
11633 San Vicente Blvd
Suite 310
Los Angeles, CA 90049-6514
Phone (310) 326-5949
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G573090 | Other | CA | BLUE SHIELD |
| P00062429 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 26, 2019 through Feb 26, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dixie D Richards MD Inc | Dermatology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dermatology Physician
- Los Angeles, CA
- NPI 1528141033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740358464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11633 SAN VICENTE BLVD",
"address_2": "SUITE 310",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496514",
"telephone_number": "310-326-5949",
"fax_number": "310-326-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11633 SAN VICENTE BLVD",
"address_2": "SUITE 310",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496514",
"telephone_number": "310-326-5949",
"fax_number": "310-326-6239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "DIXIE",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G57309",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G573090",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00062429",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.