MEDICARE: NEXT LEVEL PSYCHIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1528900735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT LEVEL PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	7777 BONHOMME AVE
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-1911
Country	:	US
Telephone Number	:	315-547-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 BONHOMME AVE
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-1911
Country	:	US
Telephone Number	:	315-547-0502
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLIN DIXON
Credential	:	PMHNP
Telephone Number	:	315-547-0502

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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