Individual provider Active NPI

Dawn C Welliver, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1255390688
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3346492 Issued in FL
Practice address
655 W 8TH St
Ufjp Anesthesia Dept
Jacksonville, FL 32209-6511
Phone
(904) 244-4195
Fax
(904) 244-4908
NPI assigned
Mar 23, 2006
Last updated
Aug 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP3346492 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Anesthesia Dept
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3199

Other identifiers 3

IdentifierTypeStateIssuer
811797032CMedicaidGA
003120326BMedicaidGA
3061990-00MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000129 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284698135 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2021 Accepting new patients
Sunbelt Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 27, 2017 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 24, 2023 Accepting new patients
Lighthouse Anesthesia LLC Past Accepting new patients
Sunbelt Visiting Primary Care LLC PastSince Jan 1, 2017 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

7051 Southpoint Pkwy S
Jacksonville, FL 32216
Phone (904) 432-1521

8833 Perimeter Park Blvd
Ste 901
Jacksonville, FL 32216
Phone (904) 240-4777

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

2438 Dr Ml King Jr St N
St Petersburg, FL 33704
Phone (727) 565-0740

Organizations & group practices 5

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1255390688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3199",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP ANESTHESIA DEPT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4195",
            "fax_number": "904-244-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLIVER",
        "first_name": "DAWN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3346492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811797032C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003120326B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3061990-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.