NPIMap

Individual provider Active NPI

Dawn A Fairley, DO

  • Family Medicine Physician
  • Unionville, MO
National Provider Identifier
1801832373
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2006023529 Issued in MO
Practice address
103 S 18TH St
Unionville, MO 63565-1642
Phone
(660) 947-2300
Fax
(660) 947-2307
NPI assigned
Jun 21, 2006
Last updated
Apr 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012469 PA
Family Medicine Physician 207Q00000X 2006023529 MO Primary
Family Medicine Physician 207Q00000X 20A 7187 CA
Family Medicine Physician 207Q00000X OS 9881 FL

Addresses

Primary practice location

103 S 18TH St
Unionville, MO 63565-1642

Mailing address

103 S 18TH St
Unionville, MO 63565-1642
Phone (660) 947-2300

Other identifiers 3

IdentifierTypeStateIssuer
207348905MedicaidMO
0019478700001MedicaidPA
961950085OtherMOMEDICARE ID - TYPE UNSPECIFIED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070110000077 MO Practitioner - Family Practice 7416842323 Reassigns benefits to 2 organizations
I20170509000654 IA Practitioner - Family PracticePractitioner - Emergency Medicine 7416842323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 S 18TH St
Unionville, MO 63565-1642
Phone (660) 947-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20A 7187CAMDFamily Medicine Physician
OS 9881FLMDFamily Medicine Physician
OS012469PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital Current Accepting new patients
Mercy Medical Center-Centerville CurrentSince Apr 7, 2017 Accepting new patients
Mercy Medical Center-Centerville Current Accepting new patients
Putnam County Medical Home Clinics, LLC Family Medicine CurrentSince Oct 24, 2016 Accepting new patients
Mercy Medical Center-Centerville CurrentSince Apr 7, 2017 Accepting new patients
Carespot Professional Services LLC PastSince Aug 4, 2015 Accepting new patients
Putnam County Nursing Home Past Accepting new patients

Locations

1 Saint Joseph Dr
Centerville, IA 52544
Phone (641) 437-3482

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

Interoperability endpoints

  • Direct secure messaging: dawn.fairley.1@14935.direct.athenahealth.com
  • Direct secure messaging: dfairley3944288@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/14935/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1801832373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S 18TH ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651642",
            "telephone_number": "660-947-2300",
            "fax_number": "660-947-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S 18TH ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651642",
            "telephone_number": "660-947-2300",
            "fax_number": "660-947-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "DAWN",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012469",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006023529",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A 7187",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 9881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207348905",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019478700001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "961950085",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Unionville, MO

Sources for this page

Verify at the official NPI Registry.