NPIMap

Organization Active NPI

Dawson Street Family Practice P.a.

  • Medical Physician Assistant
  • Wilmington, NC
National Provider Identifier
1811141849
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
153430 Issued in NC
Legal business name
DAWSON STREET FAMILY PRACTICE P.A.
Practice address
608 Dawson St
Wilmington, NC 28401-5712
Phone
(910) 667-0471
Fax
(910) 667-0475
NPI assigned
Nov 4, 2008
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Dr. Ronald Demas
Title
Medical Director / Owner
Phone
(910) 667-0471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 153430 NC Primary

Addresses

Primary practice location

608 Dawson St
Wilmington, NC 28401-5712

Mailing address

608 Dawson St
Wilmington, NC 28401-5712
Phone (910) 667-0471

National Provider Directory

National Provider Directory

Locations

608 Dawson St
Wilmington, NC 28401
Phone (910) 387-3745

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1811141849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DAWSON ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015712",
            "telephone_number": "910-667-0471",
            "fax_number": "910-667-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 DAWSON ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015712",
            "telephone_number": "910-667-0471",
            "fax_number": "910-667-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWSON STREET FAMILY PRACTICE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "DEMAS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "910-667-0471",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "153430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.