Individual provider Active NPI

Darlene Voncille Dixon-Hall, RN

  • Psychiatric/Mental Health Registered Nurse
  • Canton, MI
National Provider Identifier
1982175105
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
4704179700 Issued in MI
Practice address
43825 Michigan Ave
Canton, MI 48188-2551
Phone
(734) 397-3088
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704179700 MI Primary

Addresses

Primary practice location

43825 Michigan Ave
Canton, MI 48188-2551

Mailing address

18301 Cherrylawn St
Detroit, MI 48221-2078
Phone (313) 310-3395

Other identifiers 1

IdentifierTypeStateIssuer
4704179700OtherMIDEPART OF LICENSING AND REGULATORY AFFAIRS BOARD OF NURSING

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704179700MIMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1982175105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 CHERRYLAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212078",
            "telephone_number": "313-310-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-397-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON-HALL",
        "first_name": "DARLENE",
        "middle_name": "VONCILLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704179700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPART OF LICENSING AND REGULATORY AFFAIRS BOARD OF NURSING",
            "identifier": "4704179700",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.