Individual provider Active NPI

Mary Hebert Dawson, M.D.

  • Family Medicine Physician
  • Abingdon, VA
National Provider Identifier
1447454251
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101247313 Issued in VA
Practice address
613 Campus Dr
Suite 200
Abingdon, VA 24210-9703
Phone
(276) 628-1186
Fax
(276) 628-8507
NPI assigned
Jun 14, 2007
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101247313 VA Primary

Addresses

Primary practice location

613 Campus Dr
Suite 200
Abingdon, VA 24210-9703

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

2885 Boones Creek Rd Ste 202
Johnson City, TN 37615-8004
Phone (423) 952-8050

Other practice location 2

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other identifiers 1

IdentifierTypeStateIssuer
1447454251MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101117000767 VA Practitioner - Family Practice 4789879636 Reassigns benefits to 1 organization
I20220829003082 TN Practitioner - Family Practice 4789879636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

115 Judge Gresham Rd
Suite B
Gray, TN 37615-6213
Phone (423) 477-2010

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince May 1, 2022 Accepting new patients
Abingdon Physician Partners CurrentSince Oct 5, 2010 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince May 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

115 Judge Gresham Rd
Ste A
Gray, TN 37615
Phone (423) 467-3000

115 Judge Gresham Rd
Ste B
Gray, TN 37615
Phone (423) 477-2010

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2885 Boones Creek Rd
Ste 202
Johnson City, TN 37615
Phone (423) 952-8050

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

613 Campus Dr
Ste 200
Abingdon, VA 24210
Phone (276) 628-1186

1205 Snider St
#B
Marion, VA 24354
Phone (276) 258-1777

Organizations & group practices 4

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 6

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1447454251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 CAMPUS DR",
            "address_2": "SUITE 200",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242109703",
            "telephone_number": "276-628-1186",
            "fax_number": "276-628-8507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2885 Boones Creek Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376158004",
            "country_code": "US",
            "telephone_number": "423-952-8050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Judge Gresham Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376156213",
            "country_code": "US",
            "telephone_number": "423-467-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MARY",
        "middle_name": "HEBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101247313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447454251",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.