Bruce Lee Dawson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

750 Issued in IA

Practice address

4313 University Ave
Des Moines, IA 50311-3423

Phone

(515) 255-4211

Fax

(515) 255-4196

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902954589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113423",
            "telephone_number": "515-255-4211",
            "fax_number": "515-255-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113423",
            "telephone_number": "515-255-4211",
            "fax_number": "515-255-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "BRUCE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "43675",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199497",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Falycia Dawn Davis, LMSW
• Kathleen Carol Davis, FNP
• Logan Davis
• Mark Leroy Davis, OD
• Scott R Davison, M.D.
• Bryana Dawson, PSYCHOLOGY B.A.
• Magdalena Tatiana Dawson, APRN
• Steven T Dawson, M.D.
• Ryan Day, ARNP
• Sydney Day

• Clinical Psychologist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.