Active NPI
David Shawn Dyer, RRW
- Health Educator
- Banning, CA
National Provider Identifier
1659680965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- RW3499
- Practice address
- 245 N Murray St
Banning, CA 92220-5528 - Phone
- (951) 663-8366
- NPI assigned
- Oct 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | RW3499 | CA | Primary |
Addresses
Primary practice location
245 N Murray St
Banning, CA 92220-5528
Mailing address
245 N Murray St
Banning, CA 92220-5528
Phone (951) 663-8366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RW3499 | CA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1659680965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 N MURRAY ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922205528",
"telephone_number": "951-663-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 N MURRAY ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922205528",
"telephone_number": "951-663-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "DAVID",
"middle_name": "SHAWN",
"credential": "RRW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-04",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "CA",
"license": "RW3499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.