Dodson Pain Consultants PA Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DODSON PAIN CONSULTANTS PA CORP

Doing business as

DPC Medical

Practice address

28 Nathan LN N
Plymouth, MN 55441-6306

Phone

(763) 588-7099

Fax

(763) 522-2222

NPI assigned

Aug 28, 2012

Last updated

Feb 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David K Dodson, M.D.NPI 1164698619

Title

President

Phone

(763) 588-7099

Specialties & licenses 5

Addresses

Other names 1

• DPC MEDICAL Doing business as

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Kirk Dodson, MD

  • General Practice Physician
  • Plymouth, MN
  • NPI 1164698619
  Medicare reassignment NPD Authorized official
• Sean Sullivan Dwyer, PA-C

  • Physician Assistant
  • Edina, MN
  • NPI 1073022372
  NPD (past)

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1275881971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 NATHAN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416306",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 NATHAN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416306",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODSON PAIN CONSULTANTS PA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-588-7099",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MN",
            "license": "52435",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DPC MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Subis Dini
• Mackenzie Catherine Dircks
• Carly Dirlam, M.D.
• Kayla Marie Djonne, MSW, LICSW
• Maria Dockendorf
• David Kirk Dodson, MD
• Samantha Domagala
• Alyssa Marie Domico, DMD, MS
• Don Sealock, O.D., P.a. (Four Seasons Eyecare)
• Alicia Mae Donahue, LICSW

• Clinic/Center in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.