Provider Type Icon

JENNIFER LAUREN DALLAS MD NPI 1417046343


NPI Information

NPI: 1417046343
Provider Name: JENNIFER LAUREN DALLAS, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

PECOS Registration: Yes

Address:
2711 RANDOLPH RD STE 400
CHARLOTTE, NC
ZIP 28207
Phone: (707) 342-9577
Get Directions

Jennifer Lauren Dallas, MD is a hematology and oncology internal medicine in Charlotte, NC with 19 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Jennifer Lauren Dallas, MD NPI is 1417046343. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year:2005

The provider's business location address is:

2711 RANDOLPH RD STE 400
CHARLOTTE, NC
ZIP 28207-027
Phone: (707) 342-9577
Fax: (704) 377-0353

The NPI 1417046343 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 10/11/2006 and was last updated on 11/18/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine201500282NORTH CAROLINANo
2207R00000XInternal Medicine066472GEORGIANo
3207RH0000XInternal MedicineHematology066472GEORGIANo
4207RX0202XInternal MedicineMedical Oncology066472GEORGIANo
5207RX0202XInternal MedicineMedical Oncology201500282NORTH CAROLINANo
6207RH0003XInternal MedicineHematology & Oncology201500282NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003114517AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.