Individual provider Active NPI

Daniel P Dare, MD

  • Orthopaedic Surgery Physician
  • Vicksburg, MS
National Provider Identifier
1396773941
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
08622 Issued in MS
Practice address
2080 S Frontage Rd
Suite 113
Vicksburg, MS 39180-5328
Phone
(601) 636-1219
Fax
(601) 636-1076
NPI assigned
Jun 30, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 08622 MS Primary

Addresses

Primary practice location

2080 S Frontage Rd
Suite 113
Vicksburg, MS 39180-5328

Mailing address

PO Box 321359
Flowood, MS 39232-1359
Phone (601) 936-1395

Other identifiers 3

IdentifierTypeStateIssuer
1173622MedicaidLA
0019377MedicaidMS
4357636OtherMSAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniel.dare.1@4695.direct.athenahealth.com

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
08622MSMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Clinic LLC Orthopaedic Surgery Past Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients
River Oaks Management Company LLC Orthopaedic Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniel.dare.1@4695.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1396773941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321359",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321359",
            "telephone_number": "601-936-1395",
            "fax_number": "601-636-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "address_2": "SUITE 113",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-636-1219",
            "fax_number": "601-636-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARE",
        "first_name": "DANIEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2026-09-29",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "08622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1173622",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019377",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4357636",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.dare.1@4695.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2080 S Frontage Rd",
            "address_2": "Suite 113",
            "city": "Vicksburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391805328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.