Camille Nicole Dixon, MPAS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

22984 Issued in CA

Practice address

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Phone

(858) 859-1188

NPI assigned

May 28, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Camille Nicole Cook Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Interoperability endpoints

• Direct secure messaging: camille.dixon.1@30520.direct.athenahealth.com
• Direct secure messaging: camille.dixon@731444467007492.direct.elationemr.com

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1902243298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 S Lake Park Blvd",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841208218",
            "country_code": "US",
            "telephone_number": "801-902-4238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9525 Towne Centre Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92121",
            "country_code": "US",
            "telephone_number": "858-859-1188",
            "fax_number": "844-404-8924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9525 Towne Centre Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92121",
            "country_code": "US",
            "telephone_number": "858-859-1188",
            "fax_number": "844-404-8924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "CAMILLE",
        "middle_name": "NICOLE",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8512355-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056088",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "COOK",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dixon Orthodontic Dental Group
• Alexandra Dixon, M.A.
• Alison Marie Dixon, MD
• Amber Kay Dixon, B.A.
• Brittney Dixon
• Daisy Dixon
• Eric Hamilton Dixon, DDS
• Gary L Dixon, DC
• Gordon Hamilton Dixon, DDS
• Harry J Dixon, LMHC, LPCC, LPC, CST

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.