Jennifer Lee Dawson, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R860187 Issued in MS

Practice address

1413 W Quitman St
Iuka, MS 38852-1130

Phone

(662) 424-9550

Fax

(662) 424-9558

NPI assigned

Feb 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Stolsworth Dawson Former name

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tenn-Tom Med LLC

  • Primary Care Clinic/Center
  • Burnsville, MS
  • NPI 1174294797
  Medicare reassignment NPD
• Avalon Medical LLC

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1710216346
  NPD
• Eze Clinic P.C.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1144253279
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1710959283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521130",
            "telephone_number": "662-424-9550",
            "fax_number": "662-424-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521130",
            "telephone_number": "662-424-9550",
            "fax_number": "662-424-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R860187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07950316",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DAWSON",
            "middle_name": "STOLSWORTH",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alan R Cutshall
• Monica Jean Daugherty
• Diane L Davis, NURSE PRACTITIONER
• Dawson Drugs
• Elizabeth Senn Dawson, CRNP
• Katherine Hilda Dawson, NP-C
• Nicholas Dawson, PHARM D.
• April B. Depoyster
• Robert H Dicks, LPC
• Jacinda Dawn Dilworth, MA, CMHT

• Family Nurse Practitioner in Iuka, MS
• Providers in Iuka, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.