NPIMap

Individual provider Active NPI

Rayne Dawson, PA-C

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1871838417
Registry record updated Dec 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
PA 11108 Issued in CA
Practice address
5151 State University Dr
Student Health Center
Los Angeles, CA 90032-4226
Phone
(323) 343-3300
Fax
(323) 343-6557
NPI assigned
Dec 9, 2012
Last updated
Dec 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PA 11108 CA Primary

Addresses

Primary practice location

5151 State University Dr
Student Health Center
Los Angeles, CA 90032-4226

Mailing address

5151 State University Dr
Student Health Center
Los Angeles, CA 90032-4226
Phone (323) 343-3300

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA 11108CAMDPrimary Care Clinic/Center

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355011200000",
    "number": "1871838417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 STATE UNIVERSITY DR",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900324226",
            "telephone_number": "323-343-3300",
            "fax_number": "323-343-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 STATE UNIVERSITY DR",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900324226",
            "telephone_number": "323-343-3300",
            "fax_number": "323-343-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "RAYNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-09",
        "last_updated": "2012-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "PA 11108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2012; 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.