Dawn Renee Schreckengust, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002947 Issued in MI

Practice address

1850 Pipestone Ave.
#102-B
Benton Harbor, MI 49022-2304

Phone

(269) 925-8386

Fax

(269) 925-4085

NPI assigned

Apr 17, 2007

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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MI

  Medicare reassignment
• Great Lakes Medical Clinic, PLLC

  • Primary Care Clinic/Center
  • Benton Harbor, MI
  • NPI 1669614152
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730305160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 60TH ST",
            "city": "FENNVILLE",
            "state": "MI",
            "postal_code": "494089414",
            "telephone_number": "269-561-6023",
            "fax_number": "269-925-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 PIPESTONE AVE.",
            "address_2": "#102-B",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222304",
            "telephone_number": "269-925-8386",
            "fax_number": "269-925-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECKENGUST",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102534",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06121A",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Sassano, RDH
• Leo S Saucer, D.D.S.
• Vaida Saucer, DDS
• Alicia Sauers
• Alana Noel Scaccia
• Jennifer Ann Schroeder
• Donald Eugene Schultz II, RN
• Nicole Schultz, MA, BCBA, LBA
• Kylie Scope
• Amber Scott

• Physician Assistant in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.