DIANE DODGEN (NPI# 1134117385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134117385 |
| Entity Type | Individual |
| Full Name | DIANE DODGEN |
| Credential | M.D. |
| Practice Address |
315 E Ash St Perry FL 32347-2029 |
| Mailing Address |
330 Bishop Blvd Perry FL 32347-3618 |
| Practice Telephone | 8505843278 |
| Practice Fax Number | 8505848171 |
| Mailing Telephone | 8505843278 |
| Mailing Fax Number | 8505848171 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2017-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME99971 | FL | Allopathic & Osteopathic Physicians |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ME99971 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 279528100 | 05 |
| Street Address |
315 E ASH ST |
| City | PERRY |
| State | FL |
| Zip Code | 32347-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831184910 | Randy Hearne | Nurse Practitioner | 315 E Ash St, Perry, FL 32347-2029 | 2005-09-15 |
| 1184041741 | Pamela Sauls | Family Medicine | 315 E Ash St, Perry, FL 32347 | 2014-03-20 |
| 1811290810 | Veera Venkata S Babu Paturi | Pediatrics | 315 E Ash St, 1, Perry, FL 32347-2029 | 2010-12-13 |
| 1831342880 | Premier Medical Pediatrics Clinic Inc | Clinic/Center | 315 E Ash St, Perry, FL 32347-2029 | 2008-11-03 |
| 1942472162 | Jackie Lynn Walsingham | Massage Therapist | 315 E Ash St, Perry, FL 32347-2029 | 2008-03-27 |
| 1205885613 | Abdul Hamid Sofi | Internal Medicine | 315 E Ash St, Perry, FL 32347-2029 | 2006-05-10 |
| 1861440141 | Tae Yu | Family Medicine | 315 E Ash St, Perry, FL 32347-2029 | 2006-05-05 |
| 1518926799 | Premier Medical Clinic | Internal Medicine | 315 E Ash St, Perry, FL 32347-2029 | 2006-03-17 |
| 1710977160 | Ray Tojino Bobila | Pediatrics | 315 E Ash St, Perry, FL 32347-2029 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225250764 | Advance Speech and Language Center | Speech-Language Pathologist | 214 North Washington Street, Perry, FL 32347 | 2007-05-03 |
| 1043386865 | Doctors Memorial Hospital | Radiology | Doctors Memorial Hospital, 333 N Byron Butler Parkway, Perry, FL 32347 | 2006-11-24 |
| 1467472282 | Firas A Hamdan | Otolaryngology | 1224 N Peacock Ave, Perry, FL 32347 | 2006-07-21 |
| 1841229333 | Miles V Nelson | Surgery | 1218 N Peacock Ave, Perry, FL 32347 | 2006-06-30 |
| 1679518187 | Diane A Schlick | Family Medicine | 616 S Jefferson Street, Perry, FL 32347 | 2006-06-18 |
| 1609233170 | Rachel Gilliam | Occupational Therapy Assistant | 207 Marshall Dr, Perry, FL 32347 | 2016-01-28 |
| 1356664924 | Jacqueline Bailey | Speech-Language Pathologist | 207 Marshall Dr, Perry, FL 32347 | 2010-03-10 |
| 1831511070 | Rebecca Carroll Wambolt | Speech-Language Pathologist | 1835 Oak Ridge Ln, Perry, FL 32347-0610 | 2014-01-07 |
| 1871130856 | Carestandard Corporation | Family Medicine | 688 A B Murphy Rd, Perry, FL 32347-0810 | 2019-12-09 |
| 1912353616 | Iris Danielle Turner | Licensed Practical Nurse | 1348 Fairway Dr, Perry, FL 32347-0970 | 2016-05-11 |
| Find all providers in zip 32347 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477021053 | Regent Medical and Aesthetic Clinic | Clinic/Center | 1209 N Center St, Perry, FL 32347-2037 | 2018-11-13 |
| 1811447824 | Little Pine Pediatrics, Pllc | Clinic/Center | 1702 S Jefferson St, Perry, FL 32348-5611 | 2016-10-13 |
| 1083098388 | Coastal Complete Care | Clinic/Center | 1706 S Jefferson St, Perry, FL 32348-5611 | 2015-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.