Active NPI
Dawn Michelle Wiggins
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1790209294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW14138
- Practice address
- 7015 A C Skinner Pkwy BLDG 100
Jacksonville, FL 32256-6932 - Phone
- (904) 516-3737
- Fax
- (904) 516-3738
- NPI assigned
- Jul 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW14138 | FL | Primary |
Addresses
Primary practice location
7015 A C Skinner Pkwy BLDG 100
Jacksonville, FL 32256-6932
Mailing address
7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JD160Z | Other | FL | MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW14138 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1790209294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 A C SKINNER PKWY STE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566932",
"telephone_number": "904-363-2113",
"fax_number": "904-363-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7015 A C SKINNER PKWY BLDG 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566932",
"telephone_number": "904-516-3737",
"fax_number": "904-516-3738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "DAWN",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-27",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW14138",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "JD160Z",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.