Individual provider Active NPI

Clare Dalton Dover, M.D.

  • Anesthesiology Physician
  • Jacksonville, FL
National Provider Identifier
1851619670
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME118903 Issued in FL
Practice address
2165 Herschel St
Jacksonville, FL 32204-3819
Phone
(904) 387-4030
NPI assigned
May 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME118903 FL Primary
Anesthesiology Physician 207L00000X 36911 SC

Addresses

Primary practice location

2165 Herschel St
Jacksonville, FL 32204-3819

Mailing address

2165 Herschel St
Jacksonville, FL 32204-3819
Phone (904) 387-4030

Other identifiers 2

IdentifierTypeStateIssuer
015385700MedicaidFL
369112MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141009001313 SC Practitioner - Anesthesiology 6406076611 Reassigns benefits to 2 organizations
I20151021000895 FL Practitioner - Anesthesiology 6406076611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME118903FLMDAnesthesiology Physician
36911SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Jan 1, 2015 Accepting new patients
Greenville Health System CurrentSince Jan 1, 2015 Accepting new patients
North Florida Anesthesia Consultants Inc Anesthesiology CurrentSince Sep 14, 2015 Accepting new patients
North Florida Anesthesia Consultants, Inc. Anesthesiology CurrentSince Sep 14, 2015 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

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.

Hospital & facility affiliations 3

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": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1851619670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043819",
            "telephone_number": "904-387-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043819",
            "telephone_number": "904-387-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVER",
        "first_name": "CLARE",
        "middle_name": "DALTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-05",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME118903",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "36911",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015385700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369112",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.