Individual provider Active NPI

John Shaw Dalton II, M.D.

  • Nephrology Physician
  • Catonsville, MD
National Provider Identifier
1225013493
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0030542 Issued in MD
Practice address
2W Rolling Crossroads
Suite 205
Catonsville, MD 21228-6209
Phone
(410) 788-8033
Fax
(410) 788-8034
NPI assigned
Dec 10, 2005
Last updated
Jun 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D0030542 MD Primary

Addresses

Primary practice location

2W Rolling Crossroads
Suite 205
Catonsville, MD 21228-6209

Mailing address

2W Rolling Crossroads
Suite 205
Catonsville, MD 21228-6209
Phone (410) 788-8033

Other identifiers 1

IdentifierTypeStateIssuer
336311200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0030542MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dialysis Centers, Inc. Past Accepting new patients
Poinsett Dialysis LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1225013493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2W ROLLING CROSSROADS",
            "address_2": "SUITE 205",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286209",
            "telephone_number": "410-788-8033",
            "fax_number": "410-788-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2W ROLLING CROSSROADS",
            "address_2": "SUITE 205",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286209",
            "telephone_number": "410-788-8033",
            "fax_number": "410-788-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "JOHN",
        "middle_name": "SHAW",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-10",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0030542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336311200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.