Active NPI
Dawn M Millard, PAC
- Physician Assistant
- Hiawatha, IA
National Provider Identifier
1396723557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001472
- Practice address
- 400 S Blairsferry Xing
Hiawatha, IA 52233-7986 - Phone
- (319) 393-0783
- Fax
- (319) 393-0427
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001472 | IA | Primary |
Addresses
Primary practice location
400 S Blairsferry Xing
Hiawatha, IA 52233-7986
Mailing address
400 S Blairsferry Xing
Hiawatha, IA 52233-7986
Phone (319) 393-0783
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO00004955 | Other | IA | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9663 | MN | MD | Physical Therapist |
| 001472 | IA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1396723557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S BLAIRSFERRY XING",
"city": "HIAWATHA",
"state": "IA",
"postal_code": "522337986",
"telephone_number": "319-393-0783",
"fax_number": "319-393-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S BLAIRSFERRY XING",
"city": "HIAWATHA",
"state": "IA",
"postal_code": "522337986",
"telephone_number": "319-393-0783",
"fax_number": "319-393-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLARD",
"first_name": "DAWN",
"middle_name": "M",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "001472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "PO00004955",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hiawatha, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.