Jacqueline Dotson, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

265254-4405 Issued in UT

Practice address

736 S 900 E Ste 108
St George, UT 84790-7002

Phone

(435) 359-1401

NPI assigned

Feb 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, CA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Community Health Clinic IncGroup PAC ID 6305755455, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdotson656918@direct.ochin.org

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.

• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1497961106
  Medicare reassignment Care Compare group NPD
• Utah Surgical Associates, Inc.

  • Specialist
  • Provo, UT
  • NPI 1851450720
  Medicare reassignment NPD
• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1356714646
  NPD
• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1750809463
  NPD
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  NPD (past)
• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1811958952
  NPD (past)

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

• 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": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1174116412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "STE 200",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847904496",
            "telephone_number": "435-628-1641",
            "fax_number": "877-588-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 S 900 E STE 108",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907002",
            "telephone_number": "435-359-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "JACQUELINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "265254-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selena Donaldson
• John Thomas Dooley
• Rylee Alexis Dordahl
• Stanley Floyd Dorius
• Elizabeth J Dorsey, C.R.N.A.
• Cori Doubek
• Double Decker
• Yesenia Lisette Doudy
• Tanner Stevenson Dougherty
• Cambria Jane Douglas

• Nurse Practitioner in St George, UT
• Providers in St George, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.