Individual provider Active NPI

Addie Mae Dodson, MD

  • Pediatric Pulmonology Physician
  • Lexington, KY
National Provider Identifier
1952839847
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
54889 Issued in KY
Practice address
740 S Limestone Ste K201
Lexington, KY 40536-6062
Phone
(859) 323-6211
Fax
(859) 257-0491
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54889 KY
Pediatrics Physician 208000000X A179419 CA
Pediatric Pulmonology Physician 2080P0214X 54889 KY Primary

Addresses

Primary practice location

740 S Limestone Ste K201
Lexington, KY 40536-6062

Mailing address

4650 W Sunset Blvd # Ms 83
Los Angeles, CA 90027-6062
Phone (323) 361-2101

Other practice location 1

4650 W Sunset Blvd # MS 83
Los Angeles, CA 90027-6062
Phone (323) 361-2101

Other identifiers 1

IdentifierTypeStateIssuer
7100613620MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20210622001367 KY Practitioner - Pediatric Medicine 0143621664 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A179419CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Pediatrics CurrentSince Jun 4, 2025 Accepting new patients
University of Kentucky CurrentSince Jun 4, 2025 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1952839847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # MS 83",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2101",
            "fax_number": "323-361-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE K201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405366062",
            "telephone_number": "859-323-6211",
            "fax_number": "859-257-0491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd # MS 83",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-361-2101",
            "fax_number": "323-361-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODSON",
        "first_name": "ADDIE",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "54889",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A179419",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "KY",
            "license": "54889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100613620",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.