Active NPI
Crystal Renee Dixon, OTR/L
- Occupational Therapist
- Maynardville, TN
National Provider Identifier
1891950507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4781
- Practice address
- 215 Richardson Way
Maynardville, TN 37807-3803 - Phone
- (606) 205-2678
- Fax
- (606) 589-2522
- NPI assigned
- Jul 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | KY-R3440 | KY | |
| Occupational Therapist | 225X00000X | 4781 | TN | Primary |
Addresses
Primary practice location
215 Richardson Way
Maynardville, TN 37807-3803
Mailing address
1386 Little Valley Rd
Maynardville, TN 37807-3300
Phone (606) 205-2678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-R3440 | KY | MD | Occupational Therapist |
| 4781 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1891950507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1386 LITTLE VALLEY RD",
"city": "MAYNARDVILLE",
"state": "TN",
"postal_code": "378073300",
"telephone_number": "606-205-2678",
"fax_number": "606-589-2522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 RICHARDSON WAY",
"city": "MAYNARDVILLE",
"state": "TN",
"postal_code": "378073803",
"telephone_number": "606-205-2678",
"fax_number": "606-589-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "CRYSTAL",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-22",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "KY-R3440",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "4781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maynardville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.