Dawn Rachelle Carter
Individual provider Active NPI Case Manager/Care Coordinator · Port Wentworth, GA
NPI 1205058161 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205058161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 652152 (GA)
- Practice address
- 19 Lanvale St
Port Wentworth, GA 31407-9763 - Phone
- (912) 963-6742
- Fax
- (912) 963-0874
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 652152 | GA | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 652152 | GA | Yes |
Addresses
Primary practice location
19 Lanvale St
Port Wentworth, GA 31407-9763
Mailing address
19 Lanvale St
Port Wentworth, GA 31407-9763
Phone (912) 963-6742
Other providers in Port Wentworth, GA
- Chakita Miesha Allen
- Brittany Bell
- Heather N Bumgardner
- Care From the Start Homecare Agency, LLC
- Aisha Carrasquilla
- Angel Clark-Kennedy
- Amanda Clementz
- Latoya Sophia Cooper
- Dr Kenneith Durden Outreach
- Addie Elaine Duncan
All providers in Port Wentworth, GA · Case Manager/Care Coordinator in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.