Keisha Dixon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03540 Issued in NC

Practice address

2817 Reilly Road MCXC-Cod Credentials
Womack Army Medical Center
Fort Bragg, NC 28310

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Jun 24, 2010

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Doctors Express, PLLC

  • Urgent Care Clinic/Center
  • Cary, NC
  • NPI 1902124647

  NC

  Medicare reassignment
• DRX High Point, PLLC

  • Multi-Specialty Clinic/Center
  • High Point, NC
  • NPI 1669701306

  NC

  Medicare reassignment

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1831400845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E MILLBROOK RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094971",
            "telephone_number": "919-341-4016",
            "fax_number": "910-346-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD MCXC-COD CREDENTIALS",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Dimarucut, DNP, CRNA
• Riaz Jalal Dini, DMD
• Sandi L Distefano, CRNA
• John Thomas Distelhorst, DO, MPH, FACPM
• Ethan Dixon, RD
• Kelly Patricia Dixon, ATC
• Margaret Leah DO, RD
• Deidra Renee Dodd, BSN, DNP, FNP-C
• Michelle Anne Dodge, LCSW
• Jesse Aaron Dodson, PA

• All providers in Fort Bragg, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.