Individual provider Active NPI

Bryant H Dawson, DO

  • Internal Medicine Physician
  • Shelbyville, IN
National Provider Identifier
1992265490
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02006571A Issued in IN
Practice address
2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone
(317) 392-3211
Fax
(317) 398-1851
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 02006571A IN Primary

Addresses

Primary practice location

2451 Intelliplex Dr
Shelbyville, IN 46176-8580

Mailing address

30 W Rampart St Ste 200
Shelbyville, IN 46176-8846
Phone (317) 421-2012

Other practice location 1

8414 Naab Rd
Indianapolis, IN 46260-1972
Phone (317) 338-7510

Other identifiers 1

IdentifierTypeStateIssuer
300027784MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220317001228 IN Practitioner - Internal Medicine 4082949763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major HospitalGroup PAC ID 0446167415, 100 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone (317) 392-3211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02006571AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital CurrentSince Mar 16, 2022 Accepting new patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients
Major Hospital CurrentSince Mar 16, 2022 Accepting new patients

Locations

8414 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-1600

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1992265490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-392-3211",
            "fax_number": "317-398-1851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8414 Naab Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601972",
            "country_code": "US",
            "telephone_number": "317-338-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "BRYANT",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02006571A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300027784",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.