Audrey Mae N Rawson, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DD5246 Issued in NM

Practice address

4620 Jefferson LN NE Ste C
Albuquerque, NM 87109-2149

Phone

(505) 888-3520

NPI assigned

Jun 22, 2012

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audreymae.rawson.p1@direct.wcchc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waianae District Comprehensive Health and Hospital Board, Inc

  dba Waianae Coast Comprehensive Health Center

  • Family Medicine Physician
  • Waianae, HI
  • NPI 1275566424

  Single Specialty

  Medicare reassignment NPD
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kailua Kona, HI
  • NPI 1952335630

  Single Specialty

  Medicare reassignment NPD
• Rawson Pediatric Dental Group

  dba ABQ Pediatric Dentistry

  • Pediatric Dentistry
  • Albuquerque, NM
  • NPI 1558994582
  NPD Authorized official
• SKPD 2 LLC

  • Pediatric Dentistry
  • Waipahu, HI
  • NPI 1710739867
  NPD Authorized official
• Smiles for Keiki Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Honolulu, HI
  • NPI 1043744170
  NPD
• Waianae District Comprehensive Health and Hospital Board, Incorporated

  dba Waianae Elementary School

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1710709365
  NPD
• Waianae District Comprehensive Health and Hospital Board, Incorporated

  dba James and Abigail Campbell Clinic

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
  • NPI 1821671579
  NPD
• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1861376907
  NPD

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1215290390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 JEFFERSON LN NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092149",
            "telephone_number": "505-888-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 JEFFERSON LN NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092149",
            "telephone_number": "505-888-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 S Grand Ave Apt 503",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900152755",
            "country_code": "US",
            "telephone_number": "951-543-7439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAWSON",
        "first_name": "AUDREY MAE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "2646",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD5246",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "DT-2646",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD4404",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "2646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravensnow L.L.C.
• Katherine Choe Raver, FNP-C
• Sahil Rawal, DO
• Christine L Rawlings, CNP
• Rawson Pediatric Dental Group (ABQ Pediatric Dentistry)
• Emily Rawson
• Erica Lynn Rawson
• Allyson Marie Ray, MD
• Anissa Ray
• Ashleigh Rose Ray

• Pediatric Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.