Individual provider Active NPI

Dawn Brinkley, PA-C

  • Physician Assistant
  • Lake Mary, FL
National Provider Identifier
1114195013
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2026 Issued in FL
Practice address
410 Waymont CT
Lake Mary, FL 32746-3485
Phone
(407) 323-3550
Fax
(407) 330-5962
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2026 FL Primary

Addresses

Primary practice location

410 Waymont CT
Lake Mary, FL 32746-3485

Mailing address

410 Waymont CT
Lake Mary, FL 32746-3485
Phone (407) 323-3550

Other names 1

  • Dawn Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170510002652 FL Practitioner - Physician Assistant 8022395516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2026FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 22, 2023 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 22, 2023 Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

410 Waymont Ct
Lake Mary, FL 32746
Phone (407) 323-3550

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: dellis73340@adventhealth.direct-ci.com

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": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1114195013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463485",
            "telephone_number": "407-323-3550",
            "fax_number": "407-330-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463485",
            "telephone_number": "407-323-3550",
            "fax_number": "407-330-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "ELLIS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.