Individual provider Active NPI

Dawn Louise Brown, AGANP

  • Gerontology Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1548612666
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704260612 Issued in MI
Practice address
1000 Pavillions Cir
Traverse City, MI 49684-3198
Phone
(231) 932-3000
Fax
(231) 932-3801
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704260612 MI Primary

Addresses

Primary practice location

1000 Pavillions Cir
Traverse City, MI 49684-3198

Mailing address

PO Box 30516
Lansing, MI 48909-8016
Phone (231) 346-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160811000289 MI Practitioner - Nurse Practitioner 3577857770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704260612MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Jan 2, 2017 Accepting new patients
Munson Medical Center CurrentSince Jan 2, 2017 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1548612666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "231-346-6800",
            "fax_number": "231-346-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PAVILLIONS CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843198",
            "telephone_number": "231-932-3000",
            "fax_number": "231-932-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DAWN",
        "middle_name": "LOUISE",
        "credential": "AGANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704260612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.