Ty-Re Lamont Dixon Sr.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

220 Shoreline Dr.
Fayetteville, GA 30215

Phone

(404) 661-1800

Fax

(770) 897-3777

NPI assigned

Jan 29, 2016

Last updated

Jan 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1902264492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SHORELINE DR.",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30215",
            "telephone_number": "404-661-1800",
            "fax_number": "770-897-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SHORELINE DR.",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30215",
            "telephone_number": "404-661-1800",
            "fax_number": "770-897-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "TY-RE",
        "middle_name": "LAMONT",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Diprima, PA-C
• Diversified Personal Home Care
• Divine Design Home Care Services LL
• Felisha Nicole Dixon-Brazier, NP-C
• Andria Dixon, LMT
• DME by Preventive Health Care USA LLC
• Doctors Hospice of Georgia, Inc (Doctors Hospice of Georgia Fayetteville)
• Roselande Domond, LPC
• Christine E Donato, NP
• Joshua Adam Donis, MD

• Customized Equipment (DME) in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.