CHANTELLE RENEE DAWSON RN
NPI 1467204016
Nurse Practitioner - Adult Health in Jackson, MI

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LA2200X and a focus in Adult Health.

Active since April 04, 2024PECOS Enrolled

1100 E MICHIGAN AVE STE 307, JACKSON, MI 49201(517) 205-1594 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 30, 2026, Apr 4, 2024 (2 updates tracked since 2024).

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About Chantelle Renee Dawson Rn NPPES

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

CHANTELLE RENEE DAWSON RN (NPI 1467204016) is an individual adult health provider in Jackson, Michigan, licensed in Michigan (4704316273) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1467204016

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameCHANTELLE RENEE DAWSONCredential: RN

Location Address1100 E MICHIGAN AVE STE 307Jackson, MI 49201-1850

Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (800) 999-5829 · Fax (313) 876-1305

Phone(517) 205-1594

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateApril 4, 2024

Last NPPES UpdateMarch 30, 20262 updates tracked since enumeration

NPPES CertifiedMarch 30, 2026

✔ NPI 1467204016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in MI · 4704316273

Also ListedRegistered NurseTaxonomy 163W00000X · License 4704316273 (MI)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 4704316273 (MI)

1100 E MICHIGAN AVE STE 307, Jackson, MI 49201

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Secondary Practice Locations 2

Location 1205 N East AveJackson, MI 49201-1753 · Phone (517) 205-4800

Location 21540 E Hospital DrAnn Arbor, MI 48109-4000 · Phone (734) 936-4000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chantelle Renee Dawson Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315413705

PECOS Enrollment IDI20260414001161

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49201 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.