Individual provider Active NPI

Maurice F Dana, MD

  • Dermatology Physician
  • Newport, NC
National Provider Identifier
1437294584
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
30120 Issued in NC
Practice address
285 Howard Blvd.
Newport, NC 28570-1689
Phone
(252) 223-4054
Fax
(252) 223-2388
NPI assigned
Feb 20, 2007
Last updated
Oct 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 30120 NC Primary

Addresses

Primary practice location

285 Howard Blvd.
Newport, NC 28570-1689

Mailing address

PO Box 1689
285 Howard Blvd.
Newport, NC 28570-1689
Phone (252) 223-4054

Other identifiers 1

IdentifierTypeStateIssuer
8926870MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000600 NC Practitioner - DermatologyPractitioner - Family Practice 2769456805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30120NCMDPharmacist

Organizations & group practices 2

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1437294584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1689",
            "address_2": "285 HOWARD BLVD.",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285701689",
            "telephone_number": "252-223-4054",
            "fax_number": "252-223-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 HOWARD BLVD.",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285701689",
            "telephone_number": "252-223-4054",
            "fax_number": "252-223-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANA",
        "first_name": "MAURICE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "30120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8926870",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, NC

Sources for this page

Verify at the official NPI Registry.