Individual provider Active NPI

Dawn Hedley, RDN

  • Registered Dietitian
  • Dacula, GA
National Provider Identifier
1043737547
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004931 Issued in GA
Practice address
3567 Vern Way
Dacula, GA 30019
Phone
(678) 457-1138
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD004931 GA Primary

Addresses

Primary practice location

3567 Vern Way
Dacula, GA 30019

Mailing address

3567 Vern Way
Dacula, GA 30019-5038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405001714 TX Practitioner - Registered Dietitian Or Nutrition Professional 1759729072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
LD004931GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Mar 6, 2024 Accepting new patients

Locations

515 S Flower St
#1015
Los Angeles, CA 90071

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

1320 Main St
Ste 300
Columbia, SC 29201
Phone (803) 386-1541

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1043737547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3567 VERN WAY",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3567 VERN WAY",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "30019",
            "telephone_number": "678-457-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDLEY",
        "first_name": "DAWN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.