Jeremy Robert Dalton, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M9237 Issued in TX

Practice address

4102 24TH St Ste 103
Lubbock, TX 79410-1800

Phone

(806) 725-8760

Fax

(806) 725-8205

NPI assigned

Sep 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

University of Texas Medical School at Houston, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdalton1929070@oc.providencedirect.org

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.

• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Covenant Medical Group

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895
  NPD
• Covenant Health System

  • Land Ambulance
  • Lubbock, TX
  • NPI 1720542632
  NPD (past)
• Methodist Children'S Hospital

  • Children's Hospital
  • Lubbock, TX
  • NPI 1437171568
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223856000000",
    "number": "1578713244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-7800",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 24TH ST STE 103",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101800",
            "telephone_number": "806-725-8760",
            "fax_number": "806-725-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "JEREMY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M9237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennah Daley, M.S., LMFT-ASSOCIATE
• Steven Kent Daley
• Shana Denee Donati Dallas, LPC
• Ethan Bernell Dalley, M.D.
• Heather Dalton Dennis, LPC
• Stephen G Dalton, DO
• Vanessa Anne Dalton, MD
• Damas Dental Aesthetics PLLC
• Tina Michelle Damron, F.N.P.
• Raymond Michael Danchak, MD

• Pediatrics Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.