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LUTDAVONE KITTA DIXON APRN-FNP
NPI 1295361665
Nurse Practitioner - Family in Providence, RI

Active since March 18, 2020PECOS Enrolled
101 DUDLEY ST, PROVIDENCE, RI 02905(401) 274-1122(401) 453-7571 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 19, 2025, Sep 30, 2024, Jun 9, 2021 and 1 more (4 updates tracked since 2020).

About Lutdavone Kitta Dixon Aprn-fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUTDAVONE KITTA DIXON APRN-FNP (NPI 1295361665) is an individual family provider in Providence, Rhode Island, licensed in Rhode Island (APRN02279) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Woonsocket.

NPPES Registry Identity

NPI1295361665
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLUTDAVONE KITTA DIXONCredential: APRN-FNP
Location Address101 DUDLEY STProvidence, RI 02905-2401
Mailing Address101 Dudley StProvidence, RI 02905-2401 · (401) 274-1122 · Fax (401) 453-7571
Phone(401) 274-1122
Fax(401) 453-7571
Sole ProprietorNo
Enumeration DateMarch 18, 2020
Last NPPES UpdateMarch 19, 20254 updates tracked since enumeration
NPPES CertifiedMarch 19, 2025
✔ NPI 1295361665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in RI · APRN02279
101 DUDLEY ST, Providence, RI 02905
Open in Google Maps ↗

Secondary Practice Location 1

Location 1450 Clinton StWoonsocket, RI 02895-3207 · Phone (401) 767-4100

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lutdavone Kitta Dixon Aprn-fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Lutdavone Dixon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Affinity Physicians LLC
Same address
Anesthesiology
101 DUDLEY STREET, WIH DEPT OF ANESTHESIOLOGY
Providence, RI 02905
  • Reassigned Medicare billing, Rhode Island enrollment
  • 984 clinicians in this Medicare group
NPI 1053038471 (401) 274-1122
Thundermist Health Center
8.5 mi
Federally Qualified Health Center (FQHC)
186 PROVIDENCE ST
West Warwick, RI 02893
  • Reassigned Medicare billing, Rhode Island enrollment
  • 288 clinicians in this Medicare group
NPI 1376708560 (401) 615-2800
New England Premier Healthcare Ltd
13 mi
Internal Medicine
116 EDDIE DOWLING HWY
North Smithfield, RI 02896
  • Reassigned Medicare billing, Rhode Island enrollment
  • 18 clinicians in this Medicare group
NPI 1447799036 (401) 996-5267

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER DONALD PALMER DO
Internal Medicine
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
BRITTANY S HAMPTON MD
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
HEIDI FANION LCSW
Social Worker (Clinical)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
MS. LINDA BEETLESTONE MS
Genetic Counselor, MS
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 453-7515
JULIE ANNA KNUTSON RN, CNM
Advanced Practice Midwife
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
BETHANY DAWSON LICSW
Social Worker (Clinical)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100
HEATHER A SMITH MD, MPH
Obstetrics & Gynecology (Obstetrics)
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1122
NADINE C KASSIS MD
Obstetrics & Gynecology
101 DUDLEY ST
PROVIDENCE, RI 02905
Providence County (401) 274-1100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lutdavone Dixon's NPI number?

The NPI number for Lutdavone Dixon is 1295361665. It was assigned to this individual provider in the NPPES registry on March 18, 2020.

Where is Lutdavone Dixon located?

Lutdavone Dixon practices at 101 Dudley St, Providence, RI 02905. The listed phone number is (401) 274-1122.

What is Lutdavone Dixon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lutdavone Dixon enrolled in Medicare?

Yes. Lutdavone Dixon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lutdavone Dixon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lutdavone Dixon reassigns Medicare benefits to 3 organizations: Affinity Physicians LLC (Providence, RI), Thundermist Health Center (West Warwick, RI) and New England Premier Healthcare Ltd (North Smithfield, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lutdavone Dixon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lutdavone Dixon was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.