Individual provider Active NPI

Dawn M Ericsson, M.D.

  • Obstetrics & Gynecology Physician
  • Brandon, FL
National Provider Identifier
1639229628
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME96851 Issued in FL
Practice address
505 Oakfield Dr
Brandon, FL 33511-5700
Phone
(813) 654-2273
Fax
(813) 654-1384
NPI assigned
Jan 11, 2007
Last updated
Jun 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME96851 FL Primary

Addresses

Primary practice location

505 Oakfield Dr
Brandon, FL 33511-5700

Mailing address

505 Oakfield Dr
Brandon, FL 33511-5700
Phone (813) 654-2273

Other identifiers 1

IdentifierTypeStateIssuer
001299300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20091031000057 FL Practitioner - Obstetrics/Gynecology 5890832398 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Aug 1, 2016 Accepting new patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2016 Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Exodus Women's Center, Inc. Obstetrics & Gynecology Past Accepting new patients

Locations

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1639229628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115700",
            "telephone_number": "813-654-2273",
            "fax_number": "813-654-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115700",
            "telephone_number": "813-654-2273",
            "fax_number": "813-654-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSSON",
        "first_name": "DAWN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME96851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001299300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.