Active NPI
Rebecca L Dawley, PA-C
- Physician Assistant
- Winchester, VA
National Provider Identifier
1013167204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110006142
- Practice address
- 1828 Plaza Dr
Winchester, VA 22601-6365 - Phone
- (540) 662-9115
- Fax
- (540) 665-0411
- NPI assigned
- Sep 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110006142 | VA | Primary |
Addresses
Primary practice location
1828 Plaza Dr
Winchester, VA 22601-6365
Mailing address
PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013167204 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006151 | GA | MD | Physical Therapist |
| 0110006142 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Francis Psychiatrist ,LLC | Current | Accepting new patients | |
| St Francis Columbus Clinic LLC | Physician Assistant | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Mac-Lumpkin Rd LLC | Past | Accepting new patients |
Locations
610 19th St
Columbus, GA 31901
Phone (706) 322-7884
Interoperability endpoints
- rebecca.maricle@sfhga.gadirect.net
- rebecca.maricle@gadirect.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Columbus, GA
- NPI 1295159143
Physician Assistant
-
- Psychiatry Physician
- Columbus, GA
- NPI 1619129541
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Clinic/Center
- Columbus, GA
- NPI 1871894246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1013167204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 603725",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282603725",
"telephone_number": "828-575-2625",
"fax_number": "828-350-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1828 PLAZA DR",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226016365",
"telephone_number": "540-662-9115",
"fax_number": "540-665-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWLEY",
"first_name": "REBECCA",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-24",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110006142",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013167204",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.