Kenneth E Nixon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME48038 Issued in FL

Practice address

1760 Edgewood Ave W
Jacksonville, FL 32208-7209

Phone

(904) 253-1030

Fax

(904) 924-1773

NPI assigned

May 22, 2006

Last updated

Aug 18, 2009By 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 FL

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1851345714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "address_2": "MC #24",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-665-2410",
            "fax_number": "904-630-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-253-1030",
            "fax_number": "904-924-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIXON",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME48038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271082000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Niswander, PTA
• Jennifer Renee Nitz, OTR/L
• Nix Loving Angels LLC
• Kenneth Gordon Nix Jr., M.D.
• Amanda Victoria Nixon, PSYD
• Tiffany Nixon, BS
• Cho Nkengla
• NLD Specialists PLLC
• NLS Family Enterprise, Inc. (Foot Solutions)
• NMR Wellness Group, LLC (Superior Health & Wellness)

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.