Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fred Jeston Dawson, MD

Individual provider Diagnostic Radiology Physician · NPI 1316106131

Fred Jeston Dawson, MD is a Diagnostic Radiology in Provo, Utah. Graduated from Medical College of Wisconsin in 2007, 19 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Arizona, Indiana and Utah.

Years since qualifying
19
Trained at
Medical College of Wisconsin
Licensed in
AZ, IN, UT
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 500 W Ste 112
Provo, UT 84604-3305
Phone: (801) 812-4624
Fax: (801) 812-4699
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 9282119-1205 (UT)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 11013885A (IN)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 41926 (AZ)

Record details

NPI number1316106131
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2008
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2007 (19 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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