Organization Active NPI

Konrad L Dawson, MD, PC

  • Plastic Surgery Physician
  • Washington, DC
National Provider Identifier
1205260700
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD25996 Issued in DC
Legal business name
KONRAD L DAWSON, MD, PC
Practice address
106 Irving St NW
#2400N
Washington, DC 20010-2927
Phone
(202) 726-1000
Fax
(202) 726-1601
NPI assigned
Sep 3, 2013
Last updated
Sep 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Dr. Konrad L Dawson, M.D.NPI 1164580619
Title
President, Ceo
Phone
(202) 726-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD25996 DC Primary

Addresses

Primary practice location

106 Irving St NW
#2400N
Washington, DC 20010-2927

Mailing address

106 Irving St NW
#2400N
Washington, DC 20010-2927
Phone (202) 726-1000

Other identifiers 2

IdentifierTypeStateIssuer
527301300MedicaidMD
025425300MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130926000728 DC Part B Supplier - Clinic/Group Practice 3577707843 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

106 Irving St NW
#2400N
Washington, DC 20010
Phone (202) 726-1000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1205260700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW",
            "address_2": "#2400N",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102927",
            "telephone_number": "202-726-1000",
            "fax_number": "202-726-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW",
            "address_2": "#2400N",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102927",
            "telephone_number": "202-726-1000",
            "fax_number": "202-726-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONRAD L DAWSON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "KONRAD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "202-726-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD25996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527301300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025425300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.