Dawn C Allicock, M.D.,MPH

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

ME73935 Issued in FL

Practice address

200 San Sebastian VW
St Augustine, FL 32084-8695

Phone

(904) 209-3250

Fax

(904) 823-2580

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 14, 2016.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1356314975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAN SEBASTIAN VW",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848695",
            "telephone_number": "904-209-3250",
            "fax_number": "904-823-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAN SEBASTIAN VW",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848695",
            "telephone_number": "904-209-3250",
            "fax_number": "904-823-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLICOCK",
        "first_name": "DAWN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.,MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "ME73935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255487900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00160530",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in St Augustine, FL
• Public Health & General Preventive Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.