Active NPI
Dawson Roger Amerman, RDN
- Registered Dietitian
- Oakland, CA
National Provider Identifier
1326485889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1089489
- Practice address
- 3124 International Blvd
Oakland, CA 94601-2902 - Phone
- (510) 434-5306
- NPI assigned
- May 23, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1089489 | ID | Primary |
Addresses
Primary practice location
3124 International Blvd
Oakland, CA 94601-2902
Mailing address
3124 International Blvd
Oakland, CA 94601-2902
Phone (510) 434-5306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689863516 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1089489 | ID | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tulalip Tribes of Washington | Current | Accepting new patients | |
| Tulalip Tribes of Washington | Current | Accepting new patients | |
| Tulalip Tribes of Washington | Current | Accepting new patients |
Locations
7520 Totem Beach Rd
Tulalip, WA 98271
Phone (360) 651-4511
6406 Marine Dr
Ste A
Tulalip, WA 98271
Organizations & group practices 3
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.
-
dba Tulalip Tribes Health Clinic
- General Practice Physician
- Tulalip, WA
- NPI 1770531501
TX
-
dba Tulalip Tribes Family & Youth Services
- Substance Use Disorder Rehabilitation Clinic/Center
- Tulalip, WA
- NPI 1063502946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1326485889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3124 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012902",
"telephone_number": "510-434-5306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3124 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012902",
"telephone_number": "510-434-5306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMERMAN",
"first_name": "DAWSON",
"middle_name": "ROGER",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-23",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "1089489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689863516",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
- Ameri-Care Transit LLC
- American Current Care of California, a Medical Corporation (Concentra Urgent Care)
- American Current Care of California, a Medical Corporation (Concentra Urgent Care)
- American Indian Child Resource Center
- American Lung Association in California
- Shanise Amey
- Shirley Amey
- Hilda Ameyaw
- Maritza R. Amezcua
- Andrew Jose Amezquita
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.