Individual provider Active NPI

Tedd Eugene Dawson, MD

  • General Practice Physician
  • Willits, CA
National Provider Identifier
1457330680
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
C38007 Issued in CA
Practice address
1196 S Main St
Willits, CA 95490-4304
Phone
(707) 459-3070
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C38007 CA
General Practice Physician 208D00000X C38007 CA Primary

Addresses

Primary practice location

1196 S Main St
Willits, CA 95490-4304

Mailing address

1196 S Main St
Willits, CA 95490-4304
Phone (707) 459-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081027000413 CA Practitioner - General SurgeryPractitioner - General Practice 0143388744 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C38007CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. Current Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Jan 5, 2013 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Jan 5, 2013 Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

Interoperability endpoints

  • Direct secure messaging: tdawson335474@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1457330680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904304",
            "telephone_number": "707-459-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904304",
            "telephone_number": "707-459-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "TEDD",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C38007",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C38007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willits, CA

Sources for this page

Verify at the official NPI Registry.