Dawn Marie Baisden

Key facts

NPI

1265042915

Entity type

Individual (NPI type 1)

Primary specialty

Personal Care Attendant 3747P1801X

Practice address

1 Avenue C Ste 102
Madison, WV 25130-1100

Phone

(304) 369-6400

NPI assigned

Aug 7, 2020

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

Other names

• Dawn Marie Fletcher Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 7, 2020.

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1265042915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AVENUE C STE 102",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301100",
            "telephone_number": "304-369-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AVENUE C STE 102",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301100",
            "telephone_number": "304-369-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAISDEN",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "FLETCHER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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