DR. DAWN MICHELLE PORTER (MD) – Child & Adolescent Psychiatry Physician, NPI 1336222306
Child & Adolescent Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. DAWN MICHELLE PORTER (MD)
2120, Madison Avenue, Granite City, Madison County, Illinois, 62040, United States
SUITE 403
GRANITE CITY, IL 620404744
Phone: (618) 798-3000
Type: Mailing
1730 Prospect Ave
Kansas City, MO 641272544
Phone: (816) 404-5755
Type: Location
710 N 8th St
Springfield, IL 627026324
Phone: (217) 588-7717
Fax: (217) 525-1503
Type: Location
319 E Madison St Fl 3
Springfield, IL 627011035
Phone: (217) 545-8000
Fax: (217) 545-2275
Type: Location
1600 W Walnut St
Jacksonville, IL 626501136
Phone: (217) 545-8000
Fax: (217) 245-7427
Type: Location
PO BOX 19639
SPRINGFIELD, IL 627949639
Phone: (217) 545-8000
Fax: (217) 545-2101
Type: Mailing
319 E MADISON ST FL 2
SPRINGFIELD, IL 627011035
Phone: (217) 545-8000
Fax: (217) 545-9537
Type: Location
1730, Prospect Avenue, 18th and Vine, Kansas City, Jackson County, Missouri, 64127, United States
KANSAS CITY, MO 641272544
Phone: (816) 404-5755
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-12-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131226000272 | I | Psychiatry | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62040)
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