Individual provider Active NPI

Dawn C Brunner, MD

  • Family Medicine Physician
  • Mahomet, IL
National Provider Identifier
1063643187
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036130642 Issued in IL
Practice address
1001 Commercial Dr
Mahomet, IL 61853-8625
Phone
(217) 586-6600
Fax
(217) 366-5358
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01090197A IN
Family Medicine Physician 207Q00000X 036130642 IL Primary

Addresses

Primary practice location

1001 Commercial Dr
Mahomet, IL 61853-8625

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 586-6600

Other practice location 1

550 S Landmark Ave
Bloomington, IN 47403-3239
Phone (812) 330-3689

Other names 1

  • Dawn Witt Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dbrunnermd288426@CarleHieDirect.net Direct
Direct Messaging Address dbrunner@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121025000662 IL Practitioner - Family Practice 1355591421 Reassigns benefits to 1 organization
I20230804001955 IN Practitioner - Family Practice 1355591421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

550 S Landmark Ave
Indiana University So in Phy LLC
Bloomington, IN 47403-3239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
  • Monroe Hospital Hospital, Bloomington, IN, CCN 150183

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036130642ILMDFamily Medicine Physician
01090197AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Sep 1, 2023 Accepting new patients
Christie Clinic, PLLC Family Medicine CurrentSince Sep 1, 2012 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

1801 W Windsor Rd
Champaign, IL 61822
Phone (217) 366-5434

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

1001 Commercial Dr
Mahomet, IL 61853
Phone (217) 366-5434

550 S Landmark Ave
Bloomington, IN 47403
Phone (812) 330-3688

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: dbrunnermd288426@carlehiedirect.net
  • Direct secure messaging: dbrunner3@direct.iuhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1063643187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-586-6600",
            "fax_number": "217-366-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COMMERCIAL DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618538625",
            "telephone_number": "217-586-6600",
            "fax_number": "217-366-5358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Landmark Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033239",
            "country_code": "US",
            "telephone_number": "812-330-3689",
            "fax_number": "812-355-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "DAWN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01090197A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036130642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbrunnermd288426@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 Commercial Dr",
            "city": "Mahomet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618538625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbrunner@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474033239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "WITT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mahomet, IL

Sources for this page

Verify at the official NPI Registry.