Individual provider Active NPI

Telessa Sherran Dixon-Thomas, CD, CPD, CBC, CBE

  • Doula
  • Stone Mountain, GA
National Provider Identifier
1992451553
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
License
5062 Issued in GA
Practice address
4410 Apple Tree Dr
Stone Mountain, GA 30083-2464
Phone
(404) 312-6018
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X 5062 GA Primary

Addresses

Primary practice location

4410 Apple Tree Dr
Stone Mountain, GA 30083-2464

Mailing address

4410 Apple Tree Dr
Stone Mountain, GA 30083-2464
Phone (404) 312-6018

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

State licenses

LicenseStateTypeSpecialty
5062GAMDDoula

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1992451553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 APPLE TREE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832464",
            "telephone_number": "404-312-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 APPLE TREE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832464",
            "telephone_number": "404-312-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON-THOMAS",
        "first_name": "TELESSA",
        "middle_name": "SHERRAN",
        "credential": "CD, CPD, CBC, CBE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "GA",
            "license": "5062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.