Dovetail Pac

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

DOVETAIL PAC

Practice address

345 Neponset St Ste 3
Canton, MA 02021-1988

Phone

(781) 747-8926

NPI assigned

Jan 8, 2024

Organization subpart

No

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

Authorized official

Name

India MichelNPI 1760720213

Title

Co-Founder

Phone

(781) 747-8926

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• India S. Michel, NP

  • Family Nurse Practitioner
  • Dedham, MA
  • NPI 1760720213
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1124898440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST STE 3",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST STE 3",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211988",
            "telephone_number": "781-747-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVETAIL PAC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "INDIA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "781-747-8926"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Blaine Dodek, M.D.
• Glenn Lee Dodes, DC
• Katherine K Domoto, M.D.
• Lisa Marie Donovan, MS,CCLS,RWWP
• Rachel Alexis Dooley
• Meghan Driscoll, PSY.D
• Allan Edward Dunn, DMD
• Nicole Durning, DPT
• Shelley D Eardley
• Early Beginning Center Inc.

• Nurse Practitioner in Canton, MA
• Providers in Canton, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.