Leeroy Dixon

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

924 Emerald Bay Rd Ste A2
South Lake Tahoe, CA 96150-6434

Phone

(530) 544-2111

NPI assigned

Jun 3, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Sierra Child & Family Services

  • Community/Behavioral Health Agency
  • South Lake Tahoe, CA
  • NPI 1932527330
  NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1841031069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 EMERALD BAY RD STE A2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 EMERALD BAY RD STE A2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506434",
            "telephone_number": "530-544-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "LEEROY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Diaz
• Thomas Dickey, MFT
• Mandi Dickie
• Peter Digrande
• Julia Deborah Dirnu
• Casey Donahue
• Justin Brent Dorn, DPT
• Douglas W. Mundy
• Molly Dowd
• William Arthur Downey, OD

• Case Manager/Care Coordinator in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.