Organization Active NPI

Dawn M Gretz D P M P a

  • Customized Equipment (DME)
  • Glen Burnie, MD
National Provider Identifier
1013168566
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
DAWN M GRETZ D P M P A
Practice address
1405 Madison Park Dr
Glen Burnie, MD 21061-5627
Phone
(410) 761-1666
Fax
(410) 768-5809
NPI assigned
Oct 2, 2008
Last updated
Jan 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dawn Marie Gretz, DPMNPI 1962585208
Title
Physician
Phone
(410) 761-1666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

1405 Madison Park Dr
Glen Burnie, MD 21061-5627

Mailing address

1405 Madison Park Dr
Glen Burnie, MD 21061-5627
Phone (410) 761-1666

Other identifiers 1

IdentifierTypeStateIssuer
403210100MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Dawn M Gretz DPM PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1405 Madison Park Dr
Glen Burnie, MD 21061
Phone (410) 308-7865

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1013168566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615627",
            "telephone_number": "410-761-1666",
            "fax_number": "410-768-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615627",
            "telephone_number": "410-761-1666",
            "fax_number": "410-768-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN M GRETZ D P M P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "GRETZ",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-761-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403210100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.