Individual provider Active NPI

Dixie Autum Rochester, RN, BSN, NP

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1790707255
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP115010 Issued in TX
Practice address
703 S Fleishel Ave
Ste 5000
Tyler, TX 75701-2015
Phone
(903) 606-2830
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 679723 TX
Nurse Practitioner 363L00000X AP115010 TX Primary

Addresses

Primary practice location

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701-2015

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other practice location 1

126 W Main St Ste C
Gun Barrel City, TX 75156-5404
Phone (903) 595-2283

Other practice location 2

2001 W Ferguson Rd Ste 1000
MT Pleasant, TX 75455-2962
Phone (903) 595-2283

Other practice location 3

3201 S Loop 256
Palestine, TX 75801-6901
Phone (903) 661-7057

Other practice location 4

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

Other identifiers 7

IdentifierTypeStateIssuer
190351005MedicaidTX
190351006MedicaidTX
45-5720165OtherTXTRICARE
75-2616977-120OtherTXTRICARE
75-2616977-123OtherTXTRICARE
8858NHOtherTXBCBS
8748MCOtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060913000066 TX Practitioner - Nurse Practitioner 0244234888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

3201 S Loop
Palestine, TX 75801-6901

3203 S Main St
Christus Trinity Clinic
Lindale, TX 75771-7727
Phone (903) 266-4000

5321 S FM
14 Christus Trinity Clinic
Holly Lake Ranch, TX 75765-4839
Phone (903) 769-2990

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

650 E Lennon Dr
Christus Trinity Clinic
Emory, TX 75440-3227
Phone (903) 473-7234

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
  • Christus Mother Frances Hospital- Winnsboro Hospital, Winnsboro, TX, CCN 451381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
679723TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Apr 21, 2014 Accepting new patients
Aligned Providers of East Texas CurrentSince Mar 6, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 21, 2014 Accepting new patients
HMCC, PLLC PastSince Mar 15, 2010 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

1500 E Houston St
Beeville, TX 78102
Phone (361) 354-2000

126 W Main St
Ste C
Gun Barrel City, TX 75156
Phone (214) 912-0616

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

2001 W Ferguson Rd
Ste 1000
Mt Pleasant, TX 75455
Phone (903) 606-7480

3201 S Loop 256
Palestine, TX 75801
Phone (903) 723-0330

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701
Phone (903) 525-2992

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

1783 Troup Hwy
Tyler, TX 75701
Phone 90359522832057

Interoperability endpoints

  • Direct secure messaging: drochester355255@ahs.direct-ci.com
  • Direct secure messaging: drochester95992@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1790707255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S FLEISHEL AVE",
            "address_2": "STE 5000",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012015",
            "telephone_number": "903-606-2830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 W Main St Ste C",
            "address_purpose": "LOCATION",
            "city": "Gun Barrel City",
            "state": "TX",
            "postal_code": "751565404",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 W Ferguson Rd Ste 1000",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "TX",
            "postal_code": "754552962",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 S Loop 256",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758016901",
            "country_code": "US",
            "telephone_number": "903-661-7057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1783 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757015869",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHESTER",
        "first_name": "DIXIE",
        "middle_name": "AUTUM",
        "credential": "RN, BSN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "679723",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP115010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190351005",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190351006",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "45-5720165",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-120",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-123",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8858NH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8748MC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.