Individual provider Active NPI

Dawn Colleen Borgula, MSN, FNP-BC

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1649743832
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704267865 Issued in MI
Practice address
1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone
(231) 935-5800
Fax
(231) 935-5799
NPI assigned
Jan 10, 2019
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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 4704267865 MI Primary

Addresses

Primary practice location

1200 Sixth St Ste 200
Traverse City, MI 49684-2369

Mailing address

10442 Betsie Creek Dr
Interlochen, MI 49643-9198
Phone (231) 383-5549

Other practice location 1

1105 6th St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dborgula@direct.mhc.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200411000364 MI Practitioner - Nurse Practitioner 4284063348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

1200 6TH St
Suite 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704267865MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Feb 24, 2020 Accepting new patients
Munson Medical Group CurrentSince Feb 24, 2020 Accepting new patients

Locations

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: dborgula@direct.mhc.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1649743832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10442 BETSIE CREEK DR",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439198",
            "telephone_number": "231-383-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 6th St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORGULA",
        "first_name": "DAWN",
        "middle_name": "COLLEEN",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704267865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dborgula@direct.mhc.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 Sixth St Ste 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.