NPIMap

Individual provider Active NPI

Mark Dawson, M.D.

  • Pediatrics Physician
  • Rayne, LA
National Provider Identifier
1043210271
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L013924 Issued in LA
Practice address
717 Curtis Dr
Rayne, LA 70578-8311
Phone
(337) 334-7551
Fax
(337) 334-7556
NPI assigned
Jul 29, 2005
Last updated
May 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L013924 LA
Psychiatry Physician 2084P0800X L013924 LA
Pediatrics Physician 208000000X L013924 LA Primary

Addresses

Primary practice location

717 Curtis Dr
Rayne, LA 70578-8311

Mailing address

717 Curtis Dr
Rayne, LA 70578-8311
Phone (337) 334-7551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000954 LA Practitioner - Family PracticePractitioner - Pediatric Medicine 9032027529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pediatric Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acadiana Pediatrics, L.L.C.Group PAC ID 7113299066, 2 clinicians

Practice addresses (Care Compare)

717 Curtis Dr
Rayne, LA 70578-8311
Phone (337) 334-7554

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13924LAMDSocial Worker
L013924LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acadiana Pediatrics, L.L.C. CurrentSince May 24, 2017 Accepting new patients
Acadiana Pediatrics, L.L.C. Family Medicine CurrentSince Oct 1, 2017 Accepting new patients
Rayne Guest Home Inc Past Accepting new patients
Promise Hospital of Phoenix Inc PastSince Mar 15, 2004 Accepting new patients

Locations

717 Curtis Dr
Rayne, LA 70578
Phone (337) 334-7551

717 Curtis Dr
Ste A
Rayne, LA 70578
Phone (337) 334-7554

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acadiana Pediatrics & Family MedicineRayne, LA, CCN 193940 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer		 May 24, 2017
May 24, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1043210271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 CURTIS DR",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705788311",
            "telephone_number": "337-334-7551",
            "fax_number": "337-334-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 CURTIS DR",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705788311",
            "telephone_number": "337-334-7551",
            "fax_number": "337-334-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "L013924",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "L013924",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "L013924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rayne, LA

Sources for this page

Verify at the official NPI Registry.