Dawn Rae Mack

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906357 Issued in FL

Practice address

2104 55TH Ave W
Bradenton, FL 34207-3240

Phone

(941) 727-7304

Fax

(941) 756-0741

NPI assigned

Dec 9, 2010

Last updated

Dec 9, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Dawn Rae Paul Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1659674893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 55TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073240",
            "telephone_number": "941-727-7304",
            "fax_number": "941-756-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 55TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073240",
            "telephone_number": "941-727-7304",
            "fax_number": "941-756-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DAWN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "PAUL",
            "middle_name": "RAE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan P Macdonald
• Ashley Macha
• Koehler Zakai Machlus
• Laura Lea Machol
• Margarita Rosa Macias Duque
• Lashanti Anese Mackey, LPN
• Rachel Marie Mackey, OTR
• Susan Marie Mackey, LMHC
• Michael A Mackie, OD
• Sarah Saputo Mackie, OD

• Adult Care Home Facility in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.