Individual provider Active NPI

Dawn Miesner, D.O.

  • Family Medicine Physician
  • Mattoon, IL
National Provider Identifier
1255343026
Registry record updated Aug 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036091488 Issued in IL
Practice address
2512 Hurst Dr
Ste 120
Mattoon, IL 61938
Phone
(217) 258-5900
Fax
(217) 258-5904
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036091488 IL Primary

Addresses

Primary practice location

2512 Hurst Dr
Ste 120
Mattoon, IL 61938

Mailing address

611 W Park St
BWPC
Urbana, IL 61801
Phone (217) 383-6941

Other identifiers 1

IdentifierTypeStateIssuer
036091488MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000592 IL Practitioner - Family Practice 3476539917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

100 Lerna S Rd
Mattoon, IL 61938-9384
Phone (217) 258-5900

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036091488ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Midwest Emergency Sparta, Inc CurrentSince Jul 1, 2014 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Apr 12, 2016 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Apr 12, 2016 Accepting new patients
Hoopeston Community Memorial Hospital Family Medicine CurrentSince Apr 12, 2016 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Fastrac Medical, P.C. Past Accepting new patients
Medcare Health Center LTD Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

2512 Hurst Dr
Mattoon, IL 61938
Phone (217) 258-5900

200 Lerna Rd S
Mattoon, IL 61938
Phone (217) 258-3640

2512 Hurst Dr
Ste 120
Mattoon, IL 61938
Phone (217) 258-5900

2512 Hurst Dr
Ste 130
Mattoon, IL 61938
Phone (217) 258-5900

818 E Broadway St
Sparta, IL 62286
Phone (618) 443-2177

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: dmiesnerdo212183@carlehiedirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470441600000",
    "number": "1255343026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 HURST DR",
            "address_2": "STE 120",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-258-5900",
            "fax_number": "217-258-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIESNER",
        "first_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036091488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091488",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.