Individual provider Active NPI

Kajal Prem Dhawan, FNP-BC

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1548087141
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906954 Issued in MS
Practice address
1501 Biscayne Blvd
Miami, FL 33132-1449
Phone
(877) 870-0323
Fax
(866) 427-3798
NPI assigned
Sep 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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 906954 MS Primary

Addresses

Primary practice location

1501 Biscayne Blvd
Miami, FL 33132-1449

Mailing address

3425 Wisconsin Ave Apt 24
Vicksburg, MS 39180-5345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241018002007 MS Practitioner - Nurse Practitioner 3274065933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

907 Hwy 49 S
Richland, MS 39218-9407
Phone (601) 374-5263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
906954MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Oct 1, 2024 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Ig Health and Wellness Past Accepting new patients

Locations

760 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 748-7270

1050 Highway 98 Byp
Columbia, MS 39429
Phone (601) 522-2095

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

533 Lake St
Hazlehurst, MS 39083
Phone (601) 533-5253

1038 Northwest Ave
McComb, MS 39648
Phone (601) 730-7012

508 Highway 61 N
Natchez, MS 39120
Phone (601) 861-1631

907 Highway 49 S
Richland, MS 39218
Phone (601) 374-5263

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 5

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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1548087141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 WISCONSIN AVE APT 24",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805345",
            "fax_number": "866-427-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331321449",
            "telephone_number": "877-870-0323",
            "fax_number": "866-427-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHAWAN",
        "first_name": "KAJAL",
        "middle_name": "PREM",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.