Individual provider Active NPI

Adam Gregory Dawson, D.O.

  • Emergency Medicine Physician
  • Kingman, AZ
National Provider Identifier
1104261262
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
006725 Issued in AZ
Practice address
3269 Stockton Hill Rd
Physician Residency Office
Kingman, AZ 86409-3619
Phone
(928) 757-0649
Fax
(928) 681-8638
NPI assigned
May 2, 2013
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 006725 AZ Primary

Addresses

Primary practice location

3269 Stockton Hill Rd
Physician Residency Office
Kingman, AZ 86409-3619

Mailing address

3269 Stockton Hill Rd
Physician Residency Office
Kingman, AZ 86409-3619
Phone (928) 757-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160707002014 AZ Practitioner - Emergency Medicine 3678865821 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 757-2101

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc CurrentSince Jan 3, 2022 Accepting new patients
Arizona Emergency Medicine Specialists PC Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Kingman Healthcare, Inc CurrentSince Jan 3, 2022 Accepting new patients
Innova Emergency Medical Associates PC Emergency Medicine CurrentSince Aug 10, 2017 Accepting new patients
Kingman Healthcare, Inc Current Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients

Locations

3269 N Stockton Hill Rd
Ofc
Kingman, AZ 86409
Phone (928) 757-0649

1726 E Beverly Ave
Ste A
Kingman, AZ 86409
Phone (928) 753-3303

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1104261262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD",
            "address_2": "PHYSICIAN RESIDENCY OFFICE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-0649",
            "fax_number": "928-681-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD",
            "address_2": "PHYSICIAN RESIDENCY OFFICE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-0649",
            "fax_number": "928-681-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "ADAM",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "006725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.