WILLIE N DIXON (NPI# 1730362757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730362757 |
| Entity Type | Organization |
| Organization Name | WILLIE N DIXON |
| Other Organization Name | SHEPHERD GROVE FAMILY CARE II |
| Practice Address |
2507 Canal Dr Nw Wilson NC 27896-1325 |
| Practice Telephone | 2522917043 |
| Practice Fax Number | 2522919448 |
| Mailing Telephone | 2522917043 |
| Mailing Fax Number | 2522919448 |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MR. WILLIE N DIXON (OWNER) |
| Authorized Official Telephone | 2522439827 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | FCL-098-017 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805150 | 05 |
| Other Name | Type Code |
|---|---|
| Shepherd Grove Family Care II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003099029 | Willie N Dixon | Assisted Living Facility | 2817 Tilghman Rd N, Wilson, NC 27896-8908 | 2007-12-13 |
| Street Address |
2507 CANAL DR NW |
| City | WILSON |
| State | NC |
| Zip Code | 27896-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528543972 | Realo Discount Drug Stores of Eastern North Carolina, Inc | Durable Medical Equipment & Medical Supplies | 3724 Raleigh Road Parkway, Suite A, Wilson, NC 27896 | 2018-10-02 |
| 1518450865 | Alysann Brooke Price | Social Worker | 5878 Farmwood Loop, Wilson, NC 27896 | 2018-06-12 |
| 1144744517 | Sara Lynn Campbell | Physical Therapist | 3200 Nash Street North, Wilson, NC 27896 | 2017-07-27 |
| 1902327109 | Lamont Zebediah Barnett | Counselor | 3904 Airport Drive, Wilson, NC 27896 | 2017-06-28 |
| 1578014718 | Kristy Kaye Rowland | Counselor | 3707 Marion Court N, Wilson, NC 27896 | 2016-10-24 |
| 1780058057 | Marsha Ricketts Harper | Occupational Therapy Assistant | 3105 Senior Village Lane, Wilson, NC 27896 | 2015-11-24 |
| 1508122615 | Charlotte Hurt | Social Worker | 910 Raleigh Rd Parkway, Wilson, NC 27896 | 2012-04-03 |
| 1447542139 | Sarah Elizabeth Kirby Bischoff | Pharmacist | 3401 Raleigh Rd, Harris Teeter, Wilson, NC 27896 | 2011-05-12 |
| 1235462342 | Wilson Medical Group | Non-Pharmacy Dispensing Site | 3302 Nash St North, Wilson, NC 27896 | 2009-09-09 |
| 1164662466 | My Friend's House, LLC | Community Based Residential Treatment Facility, Mental Illness | 3607 Columbia Avenue, Wilson, NC 27896 | 2009-02-26 |
| Find all providers in zip 27896 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619397437 | Cynthia Bunch | Assisted Living Facility | 2100 Cotton Cir Se, Wilson, NC 27893-6560 | 2014-04-19 |
| 1952748329 | In God's Hands | Assisted Living Facility | 403 Harrison Dr N, Wilson, NC 27893-1717 | 2013-05-26 |
| 1164693818 | Mable Doris Holden | Assisted Living Facility | 1607 Ashland Dr, Wilson, NC 27893-1901 | 2008-03-20 |
| 1215069240 | Gregory Eugene Edwards | Assisted Living Facility | 516 Deans St W, Wilson, NC 27893-2802 | 2007-03-13 |
| 1063544096 | Willie Nathaniel Dixon | Assisted Living Facility | 2817 Tilghman Rd N, Wilson, NC 27896-8908 | 2007-03-13 |
| 1851422059 | Jkv Inc. | Assisted Living Facility | 4679 Matthews Rd, Wilson, NC 27893-7980 | 2007-03-08 |
| 1285770933 | Wilson Assisted Living | Assisted Living Facility | 3501 Senior Village Ln Nw, Wilson, NC 27896-9618 | 2007-01-29 |
| 1982750717 | Longfellow Corners Assisted Living Center | Assisted Living Facility | 420 24th Street, Wilson, KS 67490-0551 | 2007-01-26 |
| 1679621841 | Wilson House LLC | Assisted Living Facility | 1800 Martin Luther King Jr Pkwy Se, Wilson, NC 27893-6527 | 2007-01-06 |
| 1013088392 | Parkwood Village, LLC | Assisted Living Facility | 1730 Parkwood Blvd W, Wilson, NC 27893-3564 | 2006-11-10 |
| Find all providers in WILSON | ||||
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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.