Individual provider Active NPI

John Page Dana, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Fort Campbell, KY
National Provider Identifier
1740261429
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8400
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

1076 Ribaut Rd
Ste 101
Beaufort, SC 29902-5477
Phone (843) 525-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20221122000057 SC Practitioner - Physician Assistant 5294988689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1956TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Orthopaedic Alliance PA CurrentSince Jul 21, 2019 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Jul 21, 2019 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC Physician Assistant CurrentSince Oct 1, 2022 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Oct 1, 2022 Accepting new patients
Tennessee Heart and Lung Institute PLC Past Accepting new patients

Locations

1076 Ribaut Rd
Ste 101
Beaufort, SC 29902
Phone (843) 525-0045

8 City Blvd
Ste 100
Nashville, TN 37209
Phone (615) 263-0155

Interoperability endpoints

  • Direct secure messaging: john.dana.p3@direct.toa.nextgenshare.com
  • Direct secure messaging: john.dana.p2@direct.toa.nextgenshare.com
  • Direct secure messaging: john.dana.p1@direct.toa.nextgenshare.com

Organizations & group practices 5

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1740261429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "STE 101",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025477",
            "telephone_number": "843-525-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANA",
        "first_name": "JOHN",
        "middle_name": "PAGE",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.