Individual provider Active NPI

Dawn J Diaz, ARNP

  • Nurse Practitioner
  • Yulee, FL
National Provider Identifier
1366827925
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9282622 Issued in FL
Practice address
463832 State Road 200
Yulee, FL 32097-3638
Phone
(904) 225-2311
Fax
(904) 390-7467
NPI assigned
Jul 24, 2015
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X ARNP9282622 FL Primary

Addresses

Primary practice location

463832 State Road 200
Yulee, FL 32097-3638

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

Other identifiers 1

IdentifierTypeStateIssuer
016452000MedicaidFL

Other names 1

  • Dawn J Terrero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001495 FL Practitioner - Nurse Practitioner 6800194226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

45465 5TH Ave
Callahan, FL 32011-3901
Phone (904) 879-4544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Multi-Specialty CurrentSince Jun 5, 2017 Accepting new patients
Baptist Primary Care Inc Multi-Specialty CurrentSince Jun 5, 2017 Accepting new patients
Omega Health and Nutrition LLC Multi-Specialty PastSince Sep 9, 2020 Accepting new patients

Locations

45465 Fifth Ave
Callahan, FL 32011
Phone (904) 879-4544

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

463832 State Road 200
Yulee, FL 32097
Phone (904) 225-2311

Interoperability endpoints

  • Direct secure messaging: ddiaz21005@baptisthealthsystemjacksonville.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1366827925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463832 STATE ROAD 200",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320973638",
            "telephone_number": "904-225-2311",
            "fax_number": "904-390-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DAWN",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9282622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016452000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "TERRERO",
            "middle_name": "J",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yulee, FL

Sources for this page

Verify at the official NPI Registry.