Individual provider Active NPI

Jean Rodrigue Dossous, MD.

  • Medical Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1083931901
Registry record updated May 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9100887 Issued in FL
Practice address
2212 Okeechobee Rd
Fort Pierce, FL 34950-6551
Phone
(772) 465-8433
Fax
(772) 465-7276
NPI assigned
May 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9100887 FL Primary

Addresses

Primary practice location

2212 Okeechobee Rd
Fort Pierce, FL 34950-6551

Mailing address

3600 Wilderness Dr W
Fort Pierce, FL 34982-6561
Phone (772) 466-4573

Other names 1

  • Jean Marie Dossous Professional name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9100887FLMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272758400000",
    "number": "1083931901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 WILDERNESS DR W",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349826561",
            "telephone_number": "772-466-4573",
            "fax_number": "772-465-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 OKEECHOBEE RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349506551",
            "telephone_number": "772-465-8433",
            "fax_number": "772-465-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSSOUS",
        "first_name": "JEAN",
        "middle_name": "RODRIGUE",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-02",
        "last_updated": "2010-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9100887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "DOSSOUS",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2010; 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.