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DR. DAWN R. WHELCHEL M.D.
NPI 1194726299
Internal Medicine in Marshall, TX

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
401 E PINECREST DR, MARSHALL, TX 75670(903) 935-7101(903) 935-7043 Get Directions Write a Review

NPPES record last updated: October 11, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Dawn R. Whelchel M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAWN R. WHELCHEL M.D. (NPI 1194726299) is an individual internal medicine provider in Marshall, Texas, licensed in Texas (L0690) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Christus Good Shepherd Medical Center, and is a graduate of University Of Texas Medical School At San Antonio (1996).

NPPES Registry Identity

NPI1194726299
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. DAWN R. WHELCHELCredential: M.D.
Location Address401 E PINECREST DRMarshall, TX 75670-7207
Mailing Address401 E. Pinecrest DrMarshall, TX 75670-7207 · (903) 935-7101 · Fax (903) 935-7043
Phone(903) 935-7101
Fax(903) 935-7043
Sole ProprietorYes
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 1996
Enumeration DateAugust 10, 2005
Last NPPES UpdateOctober 11, 2011
✔ NPI 1194726299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · L0690
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
401 E PINECREST DR, Marshall, TX 75670
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Other Identifiers 3

Medicaid044765801TX
Medicare UPINH22428TX
Medicare ID-Type Unspecified8633K1TX · Individual Medicare Numbe

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dawn R. Whelchel M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527090299
PECOS Enrollment IDI20050901000598
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
688 services179 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
116 services16 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
116 services16 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
74 services72 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
70 services45 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
67 services67 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus Good Shepherd Medical Center

Acute Care Hospitals · Longview, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450032
Location700 E Marshall AveLongview, TX 75601 · Gregg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75670 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
16%195 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers57 claims193 services$6.35 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers22 claims36 services$0.99 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers36 claims37 services$17.58 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers63 claims64 services$85.82 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims1,500 services$0.10 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
4 suppliers19 claims1,140 services$0.83 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHELCHEL PRIMARY CARE MEDICINE PA
Internal Medicine
401 E PINECREST DR
MARSHALL, TX 75670
Harrison County (903) 935-7101
DAWN WHELCHEL MHT LLC
Internal Medicine
401 E PINECREST DR
MARSHALL, TX 75670
Harrison County (903) 935-7101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dawn Whelchel's NPI number?

The NPI number for Dawn Whelchel is 1194726299. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Dawn Whelchel located?

Dawn Whelchel practices at 401 E Pinecrest Dr, Marshall, TX 75670. The listed phone number is (903) 935-7101.

What is Dawn Whelchel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Dawn Whelchel enrolled in Medicare?

Yes. Dawn Whelchel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dawn Whelchel accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Dawn Whelchel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Dawn Whelchel affiliated with any hospitals?

According to CMS data, Dawn Whelchel is affiliated with Christus Good Shepherd Medical Center.

When was this NPI record last updated?

The NPPES record for Dawn Whelchel was last updated on October 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.