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DAWN M CARTER ARPN-CNP
NPI 1669126736
Nurse Practitioner in Lima, OH

Active since February 08, 2022PECOS EnrolledAccepts Medicare Assignment
68.75/100
CMS Quality Rating
375 N EASTOWN RD STE A, LIMA, OH 45807(419) 228-3500(419) 228-6700 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 18, 2024, Feb 8, 2022 (2 updates tracked since 2022).

About Dawn M Carter Arpn-cnp NPPES

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

DAWN M CARTER ARPN-CNP (NPI 1669126736) is an individual nurse practitioner in Lima, Ohio, licensed in Ohio (APRN.CNP.0030700) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS, is affiliated with Lima Memorial Health System, and maintains a secondary practice location in Sidney.

NPPES Registry Identity

NPI1669126736
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameDAWN M CARTERCredential: ARPN-CNP
Location Address375 N EASTOWN RD STE ALima, OH 45807-2209
Mailing Address375 N Eastown Rd Ste ALima, OH 45807-2209 · (419) 228-3500 · Fax (419) 228-6700
Phone(419) 228-3500
Fax(419) 228-6700
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateFebruary 8, 2022
Last NPPES UpdateApril 18, 20242 updates tracked since enumeration
NPPES CertifiedApril 18, 2024
✔ NPI 1669126736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OH · APRN.CNP.0030700
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
375 N EASTOWN RD STE A, Lima, OH 45807
Open in Google Maps ↗

Secondary Practice Location 1

Location 1915 Michigan St Ste 100Sidney, OH 45365-2401 · Phone (937) 494-5275 · Fax (937) 494-5276

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual.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

Dawn M Carter Arpn-cnp 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 ID244624344
PECOS Enrollment IDI20220307002298
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 9

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 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.
200 services161 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
81 services81 patients
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.
67 services61 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
30 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
27 services27 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
15 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Lima Memorial Health System

Acute Care Hospitals · Lima, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360009
Location1001 Bellefontaine AvenueLima, OH 45804 · Allen County
Emergency services Birthing friendly

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360013
Location915 West Michigan StreetSidney, OH 45365 · Shelby County
Emergency services Birthing friendly

Grand Lake Health System

Acute Care Hospitals · Saint Marys, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360032
Location200 Saint Clair StreetSaint Marys, OH 45885 · Auglaize County
Emergency services Birthing friendly

Mercer County Joint Township Community Hospital

Acute Care Hospitals · Coldwater, OH
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number360058
Location800 West Main StreetColdwater, OH 45828 · Mercer County
Birthing friendly

Mercy Health-St Rita's Medical Center

Acute Care Hospitals · Lima, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360066
Location730 West Market StreetLima, OH 45801 · Allen County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45807 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $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.

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.

68.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.57
Promoting Interoperability0
Improvement Activities40
Cost75.29

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 Carter's NPI number?

The NPI number for Dawn Carter is 1669126736. It was assigned to this individual provider in the NPPES registry on February 8, 2022.

Where is Dawn Carter located?

Dawn Carter practices at 375 N Eastown Rd Ste A, Lima, OH 45807. The listed phone number is (419) 228-3500.

What is Dawn Carter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Dawn Carter enrolled in Medicare?

Yes. Dawn Carter 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 Carter accept?

Health plans from CareSource and MedMutual list Dawn Carter 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 Carter affiliated with any hospitals?

According to CMS data, Dawn Carter is affiliated with Lima Memorial Health System, Wilson Memorial Hospital, Grand Lake Health System, Mercer County Joint Township Community Hospital and Mercy Health-St Rita's Medical Center.

When was this NPI record last updated?

The NPPES record for Dawn Carter was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.