Amanda Marie Dawicke

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0026916 Issued in OH

Practice address

1222 S Patterson Blvd Ste 230
Dayton, OH 45402-2643

Phone

(937) 853-3650

NPI assigned

Jun 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Equitas Health,IncGroup PAC ID 2769638154, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adawicke287866@direct.ochin.org

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.

• Equitas Health,Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1518227453
  Medicare reassignment Care Compare group NPD
• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951
  Medicare reassignment NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
  • NPI 1063239911
  NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Dayton, OH
  • NPI 1255846515
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1376160200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W CENTRAL AVE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450661110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD STE 230",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022643",
            "telephone_number": "937-853-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450661110",
            "country_code": "US",
            "telephone_number": "937-550-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWICKE",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0026916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "springboro",
            "affiliation": "N",
            "endpointDescription": "electronic medical record",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Cincinnati",
            "address_1": "540 W Central Ave",
            "city": "Springboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450661110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney W Davis, NNP
• Tisha Davis, AAS
• Tyesha Davis
• Elizabeth Davisson-Odle
• Davue OB/GYN Associates, Inc.
• Elizabeth M Dawkins
• Cahana Dawson-Terry
• Amber Nicole Dawson
• Jennifer L Dawson
• Marie Dawson, LPN

• Family Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.