Michael B Dixon, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

R4C21 Issued in MO

Practice address

1011 Bowles Ave Ste G10
Fenton, MO 63026-2387

Phone

(314) 842-7901

NPI assigned

Sep 1, 2006

Last updated

May 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• St. Gerard Obstetrics and Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
  • NPI 1043305428
  Authorized official Same address or phone
• Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
  • NPI 1982473153
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1780786897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 386B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-7910",
            "fax_number": "314-842-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE G10",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262387",
            "telephone_number": "314-842-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10004 Kennerly Rd",
            "address_2": "Suite 386B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282141",
            "country_code": "US",
            "telephone_number": "314-842-7910",
            "fax_number": "314-842-7911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R4C21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202681417",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdixon18043@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mdixon18043@direct-ehr-ssmhc.com",
            "address_1": "1011 Bowles Ave Ste G10",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR-API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1011 Bowles Ave Ste G10",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Jo Devine, MA, LMFT
• Dierbergs Markets, Incorporated (Dierbergs Fenton Crossing Pharmacy)
• Digital X Mobile, Inc.
• Michelle Dillon
• Lucia Dinges, RN
• Jessica Doebber
• Andrea Doerer, RN
• Dr Daniel Puetz Optometrist PC
• Dr. Petre I Anguelinin, LLC
• Douglas Dripps, M.D.

• Obstetrics & Gynecology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.