Individual provider Active NPI

Elizabeth Ann Dawson, RN/FNP/C

  • Nurse Practitioner
  • Clinton, MO
National Provider Identifier
1407804867
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
104163 Issued in MO
Practice address
1602 N 2ND St
Clinton, MO 64735
Phone
(660) 885-8171
NPI assigned
May 5, 2006
Last updated
Jan 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN104163 MO
Nurse Practitioner 363L00000X 104163 MO Primary

Addresses

Primary practice location

1602 N 2ND St
Clinton, MO 64735

Mailing address

1602 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-8171

Other practice location 1

101 Giesler Dr
Osceola, MO 64776-6297
Phone (417) 646-8123

Other practice location 2

101 Giesler Dr
Osceola, MO 64776-6297
Phone (417) 646-8123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040830000014 MO Practitioner - Nurse Practitioner 0345215869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Commercial St
Warsaw, MO 65355-3096
Phone (660) 438-5193

675 3Rd St
Osceola, MO 64776-2934
Phone (417) 646-2231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN104163MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Dec 26, 2018 Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Dec 26, 2018 Accepting new patients

Locations

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1602 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

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 1

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1407804867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "64735",
            "telephone_number": "660-885-8171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Giesler Dr",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "MO",
            "postal_code": "647766297",
            "country_code": "US",
            "telephone_number": "417-646-8123",
            "fax_number": "417-646-8984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Giesler Dr",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "MO",
            "postal_code": "647766297",
            "country_code": "US",
            "telephone_number": "417-646-8123",
            "fax_number": "417-646-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "RN/FNP/C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "RN104163",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "104163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

Verify at the official NPI Registry.