Individual provider Active NPI

Dawn Maurine Cardwell, M.D.

  • Pediatrics Physician
  • Tucker, GA
National Provider Identifier
1649236407
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
74947 Issued in GA
Practice address
200 Crescent Center Pkwy
Tucker, GA 30084-7047
Phone
(404) 365-0966
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G200163 CA
Pediatrics Physician 208000000X 74947 GA Primary

Addresses

Primary practice location

200 Crescent Center Pkwy
Tucker, GA 30084-7047

Mailing address

200 Crescent Center Pkwy
Tucker, GA 30084-7047
Phone (404) 365-0966

Other practice location 1

8640 Van Nuys Blvd
Panorama City, CA 91402-2913
Phone (818) 894-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251010000009 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719484161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G200163CAMDPediatrics Physician
74947GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric and Family Medical Center Past Accepting new patients
Community Health Centers of America Past Accepting new patients
Pediatric and Family Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dawn.cardwell.1@28334.direct.athenahealth.com
  • Direct secure messaging: dawn.cardwell@daffodilpeds.gadirect.net
  • Direct secure messaging: dawn.cardwell.p1@direct.macthealth.nextgenshare.com

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1649236407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CRESCENT CENTER PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847047",
            "telephone_number": "404-365-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CRESCENT CENTER PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847047",
            "telephone_number": "404-365-0966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8640 Van Nuys Blvd",
            "address_purpose": "LOCATION",
            "city": "Panorama City",
            "state": "CA",
            "postal_code": "914022913",
            "country_code": "US",
            "telephone_number": "818-894-8080",
            "fax_number": "818-920-9957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDWELL",
        "first_name": "DAWN",
        "middle_name": "MAURINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G200163",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "74947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.