Individual provider Active NPI

Daniel A Dotson, C.PED

  • Specialist
  • Daytona Beach, FL
National Provider Identifier
1467633891
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PED 148 Issued in FL
Practice address
2595 W International Speedway Blvd
Daytona Beach, FL 32114-1118
Phone
(386) 252-2138
Fax
(386) 252-0928
NPI assigned
Nov 14, 2007
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PED 148 FL Primary

Addresses

Primary practice location

2595 W International Speedway Blvd
Daytona Beach, FL 32114-1118

Mailing address

2595 W International Speedway Blvd
Daytona Beach, FL 32114-1118
Phone (386) 252-2138

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PED 148FLMDSpecialist

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1467633891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141118",
            "telephone_number": "386-252-2138",
            "fax_number": "386-252-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141118",
            "telephone_number": "386-252-2138",
            "fax_number": "386-252-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "DANIEL",
        "middle_name": "A",
        "credential": "C.PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PED 148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.