SHANDA SOUTHARD DIXON (NPI# 1225381767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225381767 |
| Entity Type | Individual |
| Full Name | SHANDA SOUTHARD DIXON |
| Other Name | SHANDA DAWN SOUTHARD |
| Practice Address |
1305 N Elm St Henderson KY 42420-2783 |
| Mailing Address |
105 S Elm St Henderson KY 42420-9581 |
| Practice Telephone | 2708277200 |
| Mailing Telephone | 2708277200 |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2016-03-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 3007749 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3007749 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1305 N ELM ST |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-2783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124026679 | Sheri Dawn Montgomery | Emergency Medicine | 1305 N Elm St, Er, Henderson, KY 42420-2783 | 2005-07-08 |
| 1144845868 | Laura L Kirk | Physician Assistant | 1305 N Elm St, Henderson, KY 42420-2783 | 2020-06-09 |
| 1659993582 | Deaconess Clinic, Inc | Internal Medicine | 1305 N Elm St, Henderson, KY 42420-2783 | 2020-05-14 |
| 1336768993 | Carla M Wise | Nurse Practitioner | 1305 N Elm St, Henderson, KY 42420-2783 | 2020-04-14 |
| 1528697869 | Jessica L Utley | Nurse Practitioner | 1305 N Elm St, Henderson, KY 42420-2775 | 2020-04-08 |
| 1457987877 | Tabicia Linn Mattingly | Nurse Practitioner | 1305 N Elm St, Henderson, KY 42420-2783 | 2020-03-17 |
| 1912544958 | Methodist Health, Inc. | Emergency Medicine | 1305 N Elm St, Henderson, KY 42420-2783 | 2019-12-10 |
| 1962055863 | Methodist Health, Inc. | Pharmacy | 1305 N Elm St, Henderson, KY 42420-2783 | 2019-07-19 |
| 1669034252 | Shelby Nichole Hite | Speech-Language Pathologist | 1305 N Elm St, Henderson, KY 42420-2783 | 2019-07-03 |
| 1780249060 | Methodist Health, Inc. | Anesthesiology | 1305 N Elm St, Henderson, KY 42420-2783 | 2019-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227870 | Raven Nicole Pirtle | Nurse Practitioner | 1245 Glenshiel Dr, Henderson, KY 42420-2529 | 2020-08-31 |
| 1811509359 | Kristi Lynn Navarette | Nurse Practitioner | 3058 Hushed Sonnet Ave, Henderson, NV 89044-0558 | 2020-08-17 |
| 1275143711 | Kristyn Cisilino | Nurse Practitioner | 2556 Chateau Clermont St, Henderson, NV 89044-0459 | 2020-08-07 |
| 1972113363 | Rini Susan Mathews | Nurse Practitioner | 3396 Dalmore St, Henderson, NV 89044-1722 | 2020-07-31 |
| 1033735014 | Savinder Kaur Virk | Nurse Practitioner | 10747 Shasta Glow Ct, Henderson, NV 89052-8691 | 2020-06-24 |
| 1811517022 | D Ana Curtis | Nurse Practitioner | 815 Chameleon Star Ave, Henderson, NV 89015-2411 | 2020-04-17 |
| 1275169013 | Joyce Carlos Damiano | Nurse Practitioner | 2839 Saint Rose Pkwy Ste 130, Henderson, NV 89052-4849 | 2020-03-12 |
| 1568008878 | Oliver Torrefranca | Nurse Practitioner | 910 Monte Etna Ave, Henderson, NV 89012-2654 | 2019-11-21 |
| 1568006864 | Melissa Ann Ridella | Nurse Practitioner | 1748 W Horizon Ridge Pkwy, Henderson, NV 89012-4833 | 2019-10-30 |
| 1245881317 | Edith Borgert | Nurse Practitioner | 3039 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-4193 | 2019-09-20 |
| Find all providers in HENDERSON | ||||
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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.