Jess Daniel Dawdy

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95018004 Issued in CA

Practice address

3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671

Phone

(707) 521-7777

Fax

(707) 573-5426

NPI assigned

Aug 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anderson Valley Health CenterGroup PAC ID 4789628272, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
• Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BICHAA/Endpoint/BICHAA

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.

• Anderson Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Boonville, CA
  • NPI 1568449304
  Medicare reassignment Care Compare group
• Anderson Valley Ambulance Service

  • Ambulance
  • Boonville, CA
  • NPI 1326194317
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Mendocino Coast

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Care Compare affiliation
• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1154095818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-7777",
            "fax_number": "707-573-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-521-7777",
            "fax_number": "707-573-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWDY",
        "first_name": "JESS",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "NP95018004",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell R Davis
• Richard Alan Davis, DDS
• Sharon Davis
• Sheila Rae Davis, BS
• Karen Rae Daw
• Alanna Dawkins
• Bonnie Jean Day, NP
• Jillian Day, AMFT
• Danielle J Daye
• Hailey Briana De Angelo

• Family Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.