Active NPI
Dawn Olivia Witherspoon, PHD
- Psychologist
- Jacksonville, FL
National Provider Identifier
1619301199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY 8828
- Practice address
- 6266 Dupont Station CT E
Jacksonville, FL 32217-2567 - Phone
- (904) 383-1038
- NPI assigned
- Sep 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 8828 | FL | Primary |
Addresses
Primary practice location
6266 Dupont Station CT E
Jacksonville, FL 32217-2567
Mailing address
6266 Dupont Station Court
Jacksonville, FL 32217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009650900 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 8828 | FL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1619301199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6266 DUPONT STATION COURT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6266 DUPONT STATION CT E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322172567",
"telephone_number": "904-383-1038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERSPOON",
"first_name": "DAWN",
"middle_name": "OLIVIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-03",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY 8828",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009650900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.