Audrey Simone Dawson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004139A Issued in IN

Practice address

6050 Sterling Creek Rd
Portage, IN 46368-7752

Phone

(219) 763-8112

Fax

(219) 764-5380

NPI assigned

Nov 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audrey.dawson.p1@direct.northshorehealth.nextgenshare.com

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.

• Northshore Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300
  Medicare reassignment NPD
• Dennis R Miller, O.D.

  • Optometrist
  • Warsaw, IN
  • NPI 1003819442
  Medicare reassignment
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lake Station, IN
  • NPI 1861636664

  Optometrist

  NPD

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1053889915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 STERLING CREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463687752",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "AUDREY",
        "middle_name": "SIMONE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004139A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "191360037",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021049",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taliea Crouch
• David John Cryderman, D.C.
• Jacob Cunningham
• Hasan Daik, DMD
• Daniel & Max, LLC
• Elise D Daxe
• Peter Dec, LPT
• Jennifer Leigh Defauw
• Ernest Delgado, PTA
• Veronica Deluna, RN

• Optometrist in Portage, IN
• Providers in Portage, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.