Individual provider Active NPI

Dawn Harrison

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1679021158
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11010469 Issued in FL
Practice address
501 6TH St S
St Petersburg, FL 33701-4630
Phone
(727) 767-4176
Fax
(727) 767-4379
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 APRN11010469 FL Primary

Addresses

Primary practice location

501 6TH St S
St Petersburg, FL 33701-4630

Mailing address

501 6TH St S
St Petersburg, FL 33701-4630
Phone (727) 767-4176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161201001968 NY Practitioner - Nurse Practitioner 0840570115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11010469FLMDFamily Nurse Practitioner
340879NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Bloodcare, Inc. CurrentSince Sep 28, 2016 Accepting new patients
Pediatric Physician Services, Inc. Past Accepting new patients

Locations

1010 Main St
Ste 300
Buffalo, NY 14202
Phone (716) 218-4014

Interoperability endpoints

  • Direct secure messaging: dharrison831391@direct.hopkinsmedicine.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1679021158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014630",
            "telephone_number": "727-767-4176",
            "fax_number": "727-767-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014630",
            "telephone_number": "727-767-4176",
            "fax_number": "727-767-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.