Active NPI
Kelly Nicole Nixon, DO
- Pediatrics Physician
- Evansville, IN
National Provider Identifier
1942903026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 02008979A
- Practice address
- 100 S Rosenberger Ave Ste B400
Evansville, IN 47712-6510 - Phone
- (812) 485-1566
- Fax
- (812) 485-1539
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 02008979A | IN | Primary |
| Pediatrics Physician | 208000000X | 58.033320 | OH |
Addresses
Primary practice location
100 S Rosenberger Ave Ste B400
Evansville, IN 47712-6510
Mailing address
100 S Rosenberger Ave Ste B400
Evansville, IN 47712-6510
Phone (812) 485-1566
Other practice location 1
1 Perkins Sq
Akron, OH 44308-1063
Phone (330) 543-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Marian University College of Osteopathic Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
250 W 96TH St
Indianapolis, IN 46260-1317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58.033320 | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1942903026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S ROSENBERGER AVE STE B400",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477126510",
"telephone_number": "812-485-1566",
"fax_number": "812-485-1539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S ROSENBERGER AVE STE B400",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477126510",
"telephone_number": "812-485-1566",
"fax_number": "812-485-1539"
}
],
"practiceLocations": [
{
"address_1": "1 Perkins Sq",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "OH",
"postal_code": "443081063",
"country_code": "US",
"telephone_number": "330-543-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIXON",
"first_name": "KELLY",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "02008979A",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "58.033320",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.