Individual provider Active NPI

Dawn Renee Verville, RRT

  • Neonatal/Pediatric Registered Respiratory Therapist
  • Fort Myers, FL
National Provider Identifier
1053401026
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal/Pediatric Registered Respiratory TherapistTaxonomy code 2279P3900X
License
RT 4246 Issued in FL
Practice address
9800 S Healthpark Dr
Suite #205
Fort Myers, FL 33908-7603
Phone
(239) 985-3580
Fax
(239) 985-3589
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X RT 4246 FL Primary

Addresses

Primary practice location

9800 S Healthpark Dr
Suite #205
Fort Myers, FL 33908-7603

Mailing address

9800 S Healthpark Dr
Suite #205
Fort Myers, FL 33908-7603
Phone (239) 985-3580

Other identifiers 1

IdentifierTypeStateIssuer
887983400MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
RT 4246FLMDNeonatal/Pediatric Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1053401026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 S HEALTHPARK DR",
            "address_2": "SUITE #205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339087603",
            "telephone_number": "239-985-3580",
            "fax_number": "239-985-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 S HEALTHPARK DR",
            "address_2": "SUITE #205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339087603",
            "telephone_number": "239-985-3580",
            "fax_number": "239-985-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERVILLE",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "FL",
            "license": "RT 4246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887983400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.