Individual provider Active NPI

Dawn E Kpelo

  • Phlebotomy Technician
  • St Augustine, FL
National Provider Identifier
1043009061
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Practice address
100 Center Creek Rd Ste 108
St Augustine, FL 32084-0022
Phone
(904) 522-4399
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X FL Primary

Addresses

Primary practice location

100 Center Creek Rd Ste 108
St Augustine, FL 32084-0022

Mailing address

100 Center Creek Rd Ste 108
St Augustine, FL 32084-0022
Phone (904) 522-4399

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

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1043009061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTER CREEK RD STE 108",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840022",
            "telephone_number": "904-522-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTER CREEK RD STE 108",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840022",
            "telephone_number": "904-522-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KPELO",
        "first_name": "DAWN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.