Individual provider Active NPI

Dawne R Michael, MSN, AGPCNP-C

  • Adult Health Nurse Practitioner
  • Rome, GA
National Provider Identifier
1578073565
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
205509 Issued in GA
Practice address
304 Shorter Ave NW Ste 101
Rome, GA 30165-4289
Phone
(706) 291-3700
Fax
(706) 509-3493
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 205509 GA Primary

Addresses

Primary practice location

304 Shorter Ave NW Ste 101
Rome, GA 30165-4289

Mailing address

5062 Hamby Rd NW
Acworth, GA 30102-3534
Phone (404) 663-8998

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
205509GAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1578073565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 HAMBY RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301023534",
            "telephone_number": "404-663-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SHORTER AVE NW STE 101",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654289",
            "telephone_number": "706-291-3700",
            "fax_number": "706-509-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "DAWNE",
        "middle_name": "R",
        "credential": "MSN, AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "205509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.