Active NPI
Ryan Brooks Dawson, PHARMACIST INTERN
- Student in an Organized Health Care Education/Training Program
- Dearborn Heights, MI
National Provider Identifier
1073253928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 5351010391
- Practice address
- 5709 S Telegraph Rd
Dearborn Heights, MI 48125-2025 - Phone
- (313) 292-1599
- NPI assigned
- Mar 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5351010391 | MI | Primary |
Addresses
Primary practice location
5709 S Telegraph Rd
Dearborn Heights, MI 48125-2025
Mailing address
5709 S Telegraph Rd
Dearborn Heights, MI 48125-2025
Phone (313) 292-1599
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5351010391 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
5709 S Telegraph Rd
Dearborn Hts, MI 48125
Phone (313) 292-1599
Organizations & group practices 2
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": "1648598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1073253928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5709 S TELEGRAPH RD",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481252025",
"telephone_number": "313-292-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5709 S TELEGRAPH RD",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481252025",
"telephone_number": "313-292-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "RYAN",
"middle_name": "BROOKS",
"credential": "PHARMACIST INTERN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-30",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5351010391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.