Richard Ernest Wixon Jr.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1482 Premier Village Way
Clearwater, FL 33764-2885

Phone

(727) 643-7742

NPI assigned

Jul 9, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Coastal Behavioral Services, LLC

  • Behavior Analyst
  • Tampa, FL
  • NPI 1598345514
  NPD (past)

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468022400000",
    "number": "1821440231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1482 PREMIER VILLAGE WAY",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642885",
            "telephone_number": "727-643-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1482 PREMIER VILLAGE WAY",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642885",
            "telephone_number": "727-643-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXON",
        "first_name": "RICHARD",
        "middle_name": "ERNEST",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-09",
        "last_updated": "2016-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akua Wiredu, MD
• Sydney Wiseman
• Scott Marshall Wisotsky, M.D.
• Katherine Leah Withers, PT, DPT
• Jennifer L Wixon
• Julie A Wladaver, MS
• Amanda L Wolf, AA
• Richard A Wolf II, MSN, FNP-C
• Kelsey Wolfe
• Brian G Wolstein, DC

• Community Health Worker in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2016; 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.