Individual provider Active NPI

Dawn Michele Poletaev, APRN-BC

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1467005827
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0001289 Issued in DE
Practice address
314 E Main St Ste 103
Newark, DE 19711-7180
Phone
(302) 366-0550
NPI assigned
Jul 24, 2019
Last updated
Jul 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0001289 DE Primary

Addresses

Primary practice location

314 E Main St Ste 103
Newark, DE 19711-7180

Mailing address

314 E Main St Ste 103
Newark, DE 19711-7180
Phone (302) 366-0550

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0001289DEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Sleep Lab Inc CurrentSince Jul 28, 2019 Accepting new patients

Locations

314 E Main St
Ste 103
Newark, DE 19711
Phone (302) 366-0550

Organizations & group practices 1

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1467005827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E MAIN ST STE 103",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117180",
            "telephone_number": "302-366-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E MAIN ST STE 103",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117180",
            "telephone_number": "302-366-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLETAEV",
        "first_name": "DAWN",
        "middle_name": "MICHELE",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.