Jacqueline Dallaire, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

LL84080 Issued in SC

Practice address

169 Ashley Ave
Charleston, SC 29425-1059

Phone

(843) 792-4500

NPI assigned

Jul 21, 2017

Last updated

May 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Specialty

Obstetrics/Gynecology

Education

Emory University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.dallaire@axia.eclinicaldirectplus.com

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.

• Regional Women's Health Group, LLC

  dba Axia Women's Health

  • Obstetrics & Gynecology Physician
  • Voorhees, NJ
  • NPI 1548215536
  Medicare reassignment Care Compare group NPD
• Regional Womens Health Group LLC

  dba Axia Women's Health

  • Obstetrics & Gynecology Physician
  • Phoenixville, PA
  • NPI 1750880118
  NPD

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

• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1891218863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294251059",
            "telephone_number": "843-792-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAIRE",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "LL84080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sekou Dakarai, NP
• Jeana Dealene Dale, LCSW
• Dane Nicholas Daley, M.D.
• Kristin A Daley, MD
• Leigh Watrobski Daley, P.A.
• Cordelia Elizabeth Dallam, LBA
• Dallas Southeast Long Term Acute Care, LLC (Progressive Hospital of Dallas)
• Brett Raul Dalmau, PA-C
• Kimberly Hall Dalmau, DNP, FNP-C
• Dustin Dalton, M.D.

• Obstetrics & Gynecology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Obstetrics & Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.