MR. TY-RE LAMONT DIXON SR. (NPI# 1902264492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902264492 |
| Entity Type | Individual |
| Full Name | MR. TY-RE LAMONT DIXON SR. |
| Practice Address |
220 Shoreline Dr. Fayetteville GA 30215 |
| Practice Telephone | 4046611800 |
| Practice Fax Number | 7708973777 |
| Mailing Telephone | 4046611800 |
| Mailing Fax Number | 7708973777 |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2016-01-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
GA | Suppliers |
| Street Address |
220 SHORELINE DR. |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
| 1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
| 1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
| 1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
| 1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
| 1003930454 | Michelle Marie Marchese-deutscher | Occupational Therapist | 130 Howard Lane, Fayetteville, GA 30215 | 2007-03-19 |
| Find all providers in zip 30215 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700438587 | Evelyn Ray LLC | Durable Medical Equipment & Medical Supplies | 12570 Lakeside Pkwy, Fayetteville, GA 30215-4002 | 2019-07-12 |
| 1528116530 | Summers and Koonce Inc | Durable Medical Equipment & Medical Supplies | 214 Owen Dr, Fayetteville, NC 28304-3414 | 2007-01-08 |
| 1518933217 | Ez Ryder Kreative Mobile Lifestyles Inc | Durable Medical Equipment & Medical Supplies | 10302 Fayetteville Rd, Fayetteville, NC 28304-9133 | 2006-02-23 |
| 1306186747 | Asm LLC | Durable Medical Equipment & Medical Supplies | 2603 Main Dr Ste 3, Fayetteville, AR 72704-5281 | 2013-02-21 |
| 1376783431 | Chesapeake Rehab Equipment Inc. | Durable Medical Equipment & Medical Supplies | 1111 1/2 Bragg Blvd, Fayetteville, NC 28301-4513 | 2009-03-03 |
| 1235344813 | Children's Therapy Services, Inc | Durable Medical Equipment & Medical Supplies | 2474 E Joyce Blvd, Suite 2, Fayetteville, AR 72703-4519 | 2007-05-14 |
| 1881687812 | Cumberland County Hospital System, Inc | Durable Medical Equipment & Medical Supplies | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163228 | Juanetta Barnes | Durable Medical Equipment & Medical Supplies | 2597 Thorngate Way, Acworth, GA 30101-8837 | 2020-08-06 |
| 1952919136 | Aklor Inc | Durable Medical Equipment & Medical Supplies | 2310 Parklake Dr Ne Ste 135, Atlanta, GA 30345-2913 | 2020-07-14 |
| 1285254656 | Kinetic Prosthetics & Medical Supply | Durable Medical Equipment & Medical Supplies | 3595 Hiram Douglasville Hwy Ste 102, Hiram, GA 30141-4963 | 2020-04-25 |
| 1215569843 | Jessi'ca Coley | Durable Medical Equipment & Medical Supplies | 451 Brookview Dr Ste A, Riverdale, GA 30274-7206 | 2020-02-11 |
| 1497387260 | Ogles Oxygen, LLC | Durable Medical Equipment & Medical Supplies | 5901 Goshen Springs Rd Ste G, Norcross, GA 30071-3506 | 2020-02-10 |
| 1982248969 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 4406 Mercer University Drive, Suite D, Macon, GA 31210-5608 | 2019-11-01 |
| 1548816283 | Daniel Arbuckle | Durable Medical Equipment & Medical Supplies | 2304 Pierce Way, Buford, GA 30519-2293 | 2019-08-16 |
| 1073174603 | Freedom Mobility Center, Inc. | Durable Medical Equipment & Medical Supplies | 4717 Us Highway 80 E Ste 7a, Savannah, GA 31410-2943 | 2019-06-25 |
| 1790258226 | Ariana Sade Jones | Durable Medical Equipment & Medical Supplies | 1015 Casa Dr, Clarkston, GA 30021-1109 | 2019-01-08 |
| 1710491204 | Flexforce Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3595 Hiram Douglasville Hwy Ste 220, Hiram, GA 30141-4964 | 2017-11-20 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 30215 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.