DAWN R BACK (NPI# 1841273554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841273554 |
| Entity Type | Individual |
| Full Name | DAWN R BACK |
| Credential | PA |
| Practice Address |
117 Camino De Vida Suite 300 Santa Rosa NM 88435 |
| Practice Telephone | 5754724311 |
| Practice Fax Number | 5754724313 |
| Mailing Telephone | 5754724311 |
| Mailing Fax Number | 5754724313 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2017-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2016-0044 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA.0003777 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2103 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 54452015 | 05 |
| Street Address |
117 CAMINO DE VIDA SUITE 300 |
| City | SANTA ROSA |
| State | NM |
| Zip Code | 88435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346249968 | Guadalupe County | General Acute Care Hospital | 117 Camino De Vida, 100, Santa Rosa, NM 88435-2874 | 2005-07-15 |
| 1164055927 | Sunrise Clinics | Counselor | 117 Camino De Vida, Santa Rosa, NM 88435-2267 | 2020-02-19 |
| 1720432271 | Laura Mardo | Nurse Practitioner | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | 2016-04-21 |
| 1316388051 | Michael Lee Saiz | Nurse Practitioner | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | 2013-07-10 |
| 1093153850 | Guadalupe County | Pharmacy | 117 Camino De Vida, 200, Santa Rosa, NM 88435-2267 | 2013-06-13 |
| 1326334814 | Miranda C Haley | Family Medicine | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | 2011-06-22 |
| 1730472085 | Levi Ivan Maes | Family Medicine | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | 2011-05-19 |
| 1467750653 | Cassidy Ruth Huffman | Counselor | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435 | 2011-03-11 |
| 1124107446 | Sunrise Medical Group, PC | Clinic/Center | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2874 | 2006-11-06 |
| 1639255300 | Antje Postl | Nurse Practitioner | 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | 2006-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326548322 | Katherine E Cerico | Physical Therapist | 1972 Historic Route 66, Santa Rosa, NM 88435 | 2018-02-15 |
| 1770017055 | Michael Montoya | Social Worker | 724 Park Lake Drive, Santa Rosa, NM 88435 | 2017-04-13 |
| 1447592498 | Mark Land Grossetete | Psychiatry & Neurology | 117 Camino De Vida Ste 300, Santa Rosa, NM 88435 | 2013-03-17 |
| 1962743534 | De Baca Family Practice Clinic | Clinic/Center | 552 Us Hwy 54, Santa Rosa, NM 88435 | 2013-03-07 |
| 1861728032 | Sonya Mireles | Counselor | 501 S Fourth St, Santa Rosa, NM 88435 | 2009-10-23 |
| 1255664231 | Victoria N Silva | Counselor | 501 S. Forth St., Santa Rosa, NM 88435 | 2009-09-09 |
| 1922039171 | Santa Rosa Medical Clinic | Internal Medicine | 533 Lake Dr, Santa Rosa, NM 88435 | 2006-07-06 |
| 1134455306 | Anita Valencia | Counselor | 501 S Fourth St, Santa Rosa, NM 88435 | 2009-10-23 |
| 1952621070 | Erica Nicole Romero | Social Worker | 260 N 3rd St, Santa Rosa, NM 88435-2006 | 2010-06-11 |
| 1982749453 | Guadalupe County | Pharmacy | 117 Camino De Vida Ste 200, Santa Rosa, NM 88435-2267 | 2007-02-21 |
| Find all providers in zip 88435 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139091 | Jenny Quan | Physician Assistant | 2300 Mendocino Ave Ste 4, Santa Rosa, CA 95403-3115 | 2018-10-11 |
| 1760978506 | Rhett Chandler Lacey | Physician Assistant | 545 Caber Dr, Santa Rosa, CA 95409-4404 | 2018-07-05 |
| 1417079112 | James Thomas Williams | Physician Assistant | 728 Mendocino Ave, Santa Rosa, CA 95401-4804 | 2007-04-04 |
| 1356491112 | Jaremy Lowe Kwock | Physician Assistant | 525 Doyle Park Dr Ste 102, Santa Rosa, CA 95405-4562 | 2007-01-11 |
| 1235203274 | Ann S Bruner-welch | Physician Assistant | 401 Bicentennial Way # 120, Santa Rosa, CA 95403-2149 | 2006-11-20 |
| 1770672925 | Robert Evan Crenshaw | Physician Assistant | 401 Bicentennial Way Ste 120, Santa Rosa, CA 95403-2149 | 2006-10-12 |
| 1982640298 | Amy K Jones | Physician Assistant | 1221 N Dutton Ave, Concentra Medical Group, Santa Rosa, CA 95401-4607 | 2006-06-22 |
| 1821068669 | Christine J Perkowska | Physician Assistant | 583 Summerfield Rd, Santa Rosa, CA 95405-5239 | 2006-01-24 |
| 1649265976 | Heather Noel Silva | Physician Assistant | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2005-09-13 |
| 1538167226 | Wendy A Williams | Physician Assistant | 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 | 2005-07-07 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 88435 |
Please comment or provide details below to improve the information on DAWN R BACK.
| 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.