Individual provider Active NPI

Paulette Dawkins, C.F.N.P.

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1912012121
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R813565 Issued in MS
Practice address
1612 31St Ave
Gulfport, MS 39501-2750
Phone
(228) 864-8454
Fax
(228) 865-1457
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R813565 MS Primary

Addresses

Primary practice location

1612 31St Ave
Gulfport, MS 39501-2750

Mailing address

1110 Broad Ave
Suite 700
Gulfport, MS 39501-8907
Phone (228) 864-0314

Other identifiers 2

IdentifierTypeStateIssuer
00192859OtherMSRAILROAD MEDICARE
08229286MedicaidMS

Other names 1

  • Paulette Hoda Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000403 MS Practitioner - Nurse Practitioner 8820043649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2008 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

1612 31st Ave
Gulfport, MS 39501
Phone (228) 865-1453

1110 Broad Ave
Ste 700
Gulfport, MS 39501
Phone (228) 864-0314

1340 Broad Ave
Ste 210
Gulfport, MS 39501
Phone (228) 575-1600

5120 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 868-4287

Interoperability endpoints

  • Direct secure messaging: pdawkins@direct.mhg.com

Organizations & group practices 3

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1912012121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 BROAD AVE",
            "address_2": "SUITE 700",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395018907",
            "telephone_number": "228-864-0314",
            "fax_number": "228-864-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 31ST AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012750",
            "telephone_number": "228-864-8454",
            "fax_number": "228-865-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWKINS",
        "first_name": "PAULETTE",
        "credential": "C.F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R813565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "00192859",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08229286",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULETTE",
            "last_name": "HODA",
            "credential": "C.F.N.P.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.