Individual provider Active NPI

Kenneth Alan Dakin, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1740420306
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06088 Issued in TX
Practice address
12221 Merit Dr Ste 1610
Dallas, TX 75251-2204
Phone
(214) 217-1911
Fax
(214) 217-1912
NPI assigned
Feb 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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 PA06088 TX Primary

Addresses

Primary practice location

12221 Merit Dr Ste 1610
Dallas, TX 75251-2204

Mailing address

12221 Merit Dr Ste 1610
Dallas, TX 75251-2204
Phone (214) 217-1911

Other identifiers 3

IdentifierTypeStateIssuer
284245202MedicaidTX
285297201MedicaidTX
285297203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110505000070 TX Practitioner - Physician Assistant 0749465805 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Communitymed PLLCGroup PAC ID 9830315126, 46 clinicians

Practice addresses (Care Compare)

11350 US Hwy 380
Suite 100a
Crossroads, TX 76227-8319
Phone (844) 464-1611

3210 Midwestern Pkwy
Suite 500a
Wichita Falls, TX 76308-2860
Phone (940) 488-4616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06088TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc CurrentSince Sep 1, 2019 Accepting new patients
Questcare Medical Services, PLLC Physician Assistant CurrentSince Feb 5, 2009 Accepting new patients
Olive Branch Recovery LLC Past Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Organizations & group practices 8

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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1740420306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512204",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512204",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKIN",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284245202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285297201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285297203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.