Active NPI
Derrick Lamonye Dawson Jr.
- Chiropractor
- Smyrna, GA
National Provider Identifier
1861815169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR009146
- Practice address
- 4571 Valley Pkwy SE Apt J
Smyrna, GA 30082-4942 - Phone
- (229) 563-0739
- NPI assigned
- Jan 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR009146 | GA | Primary |
| Chiropractor | 111N00000X | CH 10727 | FL | |
| Registered Dietitian | 133V00000X | LD004157 | GA |
Addresses
Primary practice location
4571 Valley Pkwy SE Apt J
Smyrna, GA 30082-4942
Mailing address
4571 Valley Pkwy SE Apt J
Smyrna, GA 30082-4942
Phone (229) 563-0739
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 |
|---|---|---|---|
| CH 10727 | FL | MD | Chiropractor |
| CHIR009146 | GA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1861815169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4571 VALLEY PKWY SE APT J",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300824942",
"telephone_number": "229-563-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4571 VALLEY PKWY SE APT J",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300824942",
"telephone_number": "229-563-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "DERRICK",
"middle_name": "LAMONYE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-23",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR009146",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH 10727",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004157",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.