Individual provider Active NPI

Joe Mathis Dixon, O.D.

  • Optometrist
  • Perry, GA
National Provider Identifier
1770540676
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 001187 Issued in GA
Practice address
1105 Morningside Dr
Perry, GA 31069-2905
Phone
(478) 987-5500
Fax
(478) 988-4628
NPI assigned
Apr 26, 2006
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 001187 GA Primary

Addresses

Primary practice location

1105 Morningside Dr
Perry, GA 31069-2905

Mailing address

1105 Morningside Dr
Perry, GA 31069-2905
Phone (478) 987-5500

Other identifiers 2

IdentifierTypeStateIssuer
000415258BMedicaidGA
000415258CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101214000981 GA Practitioner - Optometry 3476630625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dalton Family Eyecare, Inc.Group PAC ID 2466476270, 11 clinicians

Practice addresses (Care Compare)

1105 Morningside Dr
Perry, GA 31069-2905
Phone (478) 987-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 001187GAMDOptometrist
1187GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dalton Family Eyecare, Inc. Optometrist CurrentSince Aug 2, 2024 Accepting new patients

Locations

1801 Highway 129 S
Cleveland, GA 30528
Phone (706) 219-4444

134 Ansley Dr
Ste 300
Dahlonega, GA 30533
Phone (706) 219-4444

1105 Morningside Dr
Perry, GA 31069
Phone (478) 987-2020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1770540676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MORNINGSIDE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692905",
            "telephone_number": "478-987-5500",
            "fax_number": "478-988-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MORNINGSIDE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692905",
            "telephone_number": "478-987-5500",
            "fax_number": "478-988-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "JOE",
        "middle_name": "MATHIS",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT 001187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000415258B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000415258C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, GA

Sources for this page

Verify at the official NPI Registry.