Individual provider Active NPI

Dawn Davis

  • Licensed Practical Nurse
  • Watertown, NY
National Provider Identifier
1750195202
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
341308 Issued in NY
Practice address
211 JB Wise PL
Watertown, NY 13601-2507
Phone
(315) 782-7445
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 341308 NY Primary

Addresses

Primary practice location

211 JB Wise PL
Watertown, NY 13601-2507

Mailing address

1704 State St
Watertown, NY 13601-3102
Phone (315) 782-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
341308NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Home of Jefferson County CurrentSince Feb 9, 2025 Accepting new patients
Children'S Home of Jefferson County CurrentSince Feb 9, 2025 Accepting new patients

Locations

1704 State St
Watertown, NY 13601
Phone (315) 788-7430

211 Jb Wise Pl
Watertown, NY 13601
Phone (315) 788-7430

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": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1750195202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013102",
            "telephone_number": "315-782-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 JB WISE PL",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012507",
            "telephone_number": "315-782-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "341308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.