Pierce Kendal Dixon III, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18484 Issued in GA

Practice address

690 Medical Park Lane
Gainesville, GA 30501

Phone

(770) 531-0093

Fax

(770) 535-0094

NPI assigned

Mar 1, 2006

Last updated

Jan 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1811964539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 MEDICAL PARK LANE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-531-0093",
            "fax_number": "770-535-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MEDICAL PARK LANE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-531-0093",
            "fax_number": "770-535-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "PIERCE",
        "middle_name": "KENDAL",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "18484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00960396A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Grind Wellness, LLC
• Cory Jacob Dixon, DO
• David Bradley Dixon, DMD
• Jennifer Renee Dixon, ATC
• Marla Teat Dixon, PA-C
• Dlux Consulting, LLC (Bison Diagnostics)
• Emory Van DO, M.D.
• Kourtney Lauren Dockery, LPC
• Whitney Leanne Dockery, CNM
• Jennifer Erin Dodd, AGACNP

• Surgery Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.