Myrlande Dixon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3055 Issued in TN

Practice address

5380 Hickory Hollow Pkwy
Ste 201
Antioch, TN 37013-3117

Phone

(615) 891-2070

Fax

(615) 891-2056

NPI assigned

Dec 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Advanced Diagnostic Imaging, PC

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  NPD (past)
• Precision Pain Care PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Smyrna, TN
  • NPI 1013930494
  NPD (past)
• Florida Musculoskeletal Surgical Group LLC

  • Orthopaedic Surgery Physician
  • St Petersburg, FL
  • NPI 1073850160
  NPD (past)

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1922406297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 HICKORY HOLLOW PKWY",
            "address_2": "STE 201",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133117",
            "telephone_number": "615-891-2070",
            "fax_number": "615-891-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 HICKORY HOLLOW PKWY",
            "address_2": "STE 201",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133117",
            "telephone_number": "615-891-2070",
            "fax_number": "615-891-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "MYRLANDE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108246",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "3055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5200868",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PA9108246",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y0Q74",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1125636",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Antioch, TN
• Providers in Antioch, TN by specialty
• Surgical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.