Dawn Rene', Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DAWN RENE', INC.

Doing business as

Vernon Family Health of Chipley

Practice address

719 7TH St Ste 2
Chipley, FL 32428-1935

Phone

(850) 676-4287

Fax

(850) 676-4292

NPI assigned

May 28, 2006

Last updated

Nov 7, 2022By 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

Ms. Dawn Rene' Frost, ARNP-BCNPI 1215981667

Title

Owner

Phone

(850) 676-4287

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Vernon Family Health of Chipley Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326095944. Details of each certification follow.

• CCN 108989 Rural health clinic · Active · Details

Rural health clinic certification: CCN 108989

Legal name

DAWN RENE', INC.

Doing business as

VERNON FAMILY HEALTH CENTER OF CHIPLEY

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jan 13, 2006

Last certification

Aug 8, 2024

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Mar 18, 2002 in FL

Enrollment address

719 7TH St
Ste 2
Chipley, FL 32428-1935

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Dawn Rene Frost, 363L00000X

  • Family Nurse Practitioner
  • The Villages, FL
  • NPI 1215981667

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

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.

• Dawn Rene Frost, 363L00000X

  • Family Nurse Practitioner
  • The Villages, FL
  • NPI 1215981667
  Medicare reassignment NPD Authorized official
• Michelle Joy Daniels, RN

  • Family Nurse Practitioner
  • Vernon, FL
  • NPI 1851819809
  NPD

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1326095944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 7TH ST STE 2",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324281935",
            "telephone_number": "850-676-4287",
            "fax_number": "850-676-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 7TH ST STE 2",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324281935",
            "telephone_number": "850-676-4287",
            "fax_number": "850-676-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN RENE', INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "RENE'",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-676-4287",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "AR2003622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y9052",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIPASS",
            "identifier": "30289900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306088800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-RIVERBEND",
            "identifier": "108989",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vernon Family Health of Chipley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rural Health Clinic/Center in Chipley, FL
• Providers in Chipley, FL by specialty
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.