RUSSELL LOUIS DIXON (NPI# 1144503962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144503962 |
| Entity Type | Individual |
| Full Name | RUSSELL LOUIS DIXON |
| Credential | PSY.D. |
| Practice Address |
1500 N Westwood Blvd Poplar Bluff MO 63901-3318 |
| Practice Telephone | 5736864151 |
| Mailing Telephone | 5736864151 |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2013-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 90-09P | AR | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 90-09P | AR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
90-09P | AR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174156251 | Russell Dean Dixon | Case Manager/Care Coordinator | 515 Dayton St, Hamilton, OH 45011-3455 | 2020-02-18 |
| 1992093066 | Russell Dixon | Physician Assistant | 5950 University Ave Ste 105, West Des Moines, IA 50266-7756 | 2011-07-11 |
| 1689766388 | Russell Alexander Dixon Jr. | Dentist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-09-29 |
| 1457328189 | Russell M Dixon | Internal Medicine | 451 Junction Rd, Madison, WI 53717 | 2006-03-01 |
| Street Address |
1500 N WESTWOOD BLVD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142256 | Jeffrey Lee Dakas | Internal Medicine | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2005-05-24 |
| 1184244493 | Kristy Michelle Keirsey | Dental Hygienist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2020-04-16 |
| 1538788310 | Wendy Lynn Weston | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2020-04-13 |
| 1841842713 | Lyrra Suszanne Stucker | Registered Nurse | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2019-07-11 |
| 1043874803 | Deirdre Stocks | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2019-04-26 |
| 1053892026 | Janet Lee Turner | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2018-08-27 |
| 1215450291 | Richard Ladka | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-07-20 |
| 1285157388 | Jessica Lynn Libla | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-07-20 |
| 1780107995 | Hannah Irene Terry | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901 | 2017-07-19 |
| 1780112953 | Lyntoria Rochelle Williams | Social Worker | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2017-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
| 1780127449 | Gateway Neuropsychology, LLC | Clinical Neuropsychologist | 989 Gardenview Office Pkwy, Creve Coeur, MO 63141-5917 | 2016-11-29 |
| 1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
| 1578909925 | Sharon Brooks | Clinical Neuropsychologist | 2209 Potomac Dr, Columbia, MO 65203-5886 | 2013-05-13 |
| 1306190913 | Robert L Coffman | Clinical Neuropsychologist | 1245 N Butterfield Rd Ste C1, Bolivar, MO 65613-3017 | 2012-11-05 |
| 1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
| 1750612925 | Stress Control Center Inc, P C | Clinical Neuropsychologist | 800 W 47th St Ste 514, Kansas City, MO 64112-1247 | 2010-01-27 |
| 1366694937 | Dawn Heather Huber | Clinical Neuropsychologist | 175 S Marshall St, Suite G, Rogersville, MO 65742-8828 | 2008-10-15 |
| 1689852253 | Stacey Woodrome | Clinical Neuropsychologist | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2008-02-06 |
| 1659551406 | Wright & Wright, Phd, LLC | Clinical Neuropsychologist | 16141 Swingley Ridge Rd, Suite 106, Chesterfield, MO 63017-1774 | 2007-11-09 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.