Jacqui M Dawson, D.O.

Individual provider Active NPI Family Medicine Physician · Riverview, FL

NPI 1962514745 · NPPES record last updated Aug 25, 2021

Key facts

NPI
1962514745
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS0006656 (FL)
Practice address
7229 US Highway 301 S
Riverview, FL 33578-4346
Phone
(813) 677-8418
Fax
(813) 864-8018
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 14

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.

Hospital & facility affiliations 3

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

Medicare Care Compare profile

Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLC (407 clinicians)

Practice addresses (Care Compare)

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

7229 US Hwy 301 S
Riverview, FL 33578-4346
Phone (813) 677-8418

Hospital & facility affiliations

  • Amedisys Home Health Home health agency · Winter Haven, FL · CCN 107007
  • St Josephs Hospital Hospital · Tampa, FL · CCN 100075

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100924001239 FL Practitioner - Family Practice 3779624465 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0006656FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC Current
since Apr 1, 2024
Accepting new patients
Florida Medical Clinic, LLC Current
since Jun 1, 2013
Accepting new patients
Florida Medical Clinic LLC Current
since Jun 1, 2013
Accepting new patients
Family Medical Care of Riverview PA Family Medicine Current Accepting new patients
Ohi West Medical Group II LLC Current
since Apr 1, 2024
Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

7229 US Highway 301 S
Riverview, FL 33578
Phone (813) 677-8418

6037 Winthrop Commerce Ave
Ste 201
Riverview, FL 33578
Phone (813) 677-8418

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0006656 FL Yes

Addresses

Primary practice location

7229 US Highway 301 S
Riverview, FL 33578-4346

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers

IdentifierTypeStateIssuer
253225500MedicaidFL
P01202207OtherFLR&R MEDICARE

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address fmcr@flmed.directbygreenway.com Health Information Exchange (HIE)

Other providers in Riverview, FL

All providers in Riverview, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.