Individual provider Active NPI

Dawn Maxwell, CRNP

  • Family Nurse Practitioner
  • Canfield, OH
National Provider Identifier
1639908593
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0037093 Issued in OH
Practice address
601 E Main St
Canfield, OH 44406-9028
Phone
(866) 389-2727
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0037093 OH Primary

Addresses

Primary practice location

601 E Main St
Canfield, OH 44406-9028

Mailing address

3116 Heatherbrae Dr
Youngstown, OH 44514-1846
Phone (330) 360-9274

Other names 1

  • Dawn Kabetso Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241211002600 OH Practitioner - Nurse Practitioner 2466988654 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Ohio LLCGroup PAC ID 2961425608, 192 clinicians

Practice addresses (Care Compare)

601 E Main St
Canfield, OH 44406-9028
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0037093OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care Ohio LLC Family CurrentSince Aug 1, 2025 Accepting new patients
Minuteclinic Diagnostic of Ohio LLC Family CurrentSince Sep 26, 2024 Accepting new patients
Community Care Health Network LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

601 E Main St
Canfield, OH 44406
Phone (330) 702-8031

4961 Roberts Rd
Hilliard, OH 43026
Phone (614) 850-2407

1690 Woodlands Dr
Ste 200
Maumee, OH 43537
Phone (419) 491-0420

1100 Hill Rd N
Pickerington, OH 43147
Phone (614) 572-6610

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1639908593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 HEATHERBRAE DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445141846",
            "telephone_number": "330-360-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E MAIN ST",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069028",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "DAWN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0037093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "KABETSO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canfield, OH

Sources for this page

Verify at the official NPI Registry.