Individual provider Active NPI

Dale Anthony Gallo Jr., DPT

  • Physical Therapist
  • Fayetteville, NC
National Provider Identifier
1003358532
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19856 Issued in NC
Practice address
4140 Ferncreek Dr Ste 802
Fayetteville, NC 28314-2572
Phone
(910) 484-2171
Fax
(910) 484-4568
NPI assigned
Nov 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8398 SC
Physical Therapist 225100000X P19856 NC Primary

Addresses

Primary practice location

4140 Ferncreek Dr Ste 802
Fayetteville, NC 28314-2572

Mailing address

4140 Ferncreek Dr Ste 802
Fayetteville, NC 28314-2572
Phone (910) 484-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8398SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Jan 22, 2017 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Creative Health Care Management, LLC Physical Therapist CurrentSince Mar 1, 2022 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Mar 1, 2022 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Jan 22, 2017 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

10 S 9th St
Ste 4
Noblesville, IN 46060

710 Hopewell Dr
Ste 110
Charleston, SC 29492
Phone (843) 972-8709

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

11951 Grandhaven Dr
Murrells Inlet, SC 29576
Phone (843) 357-0200

3545 Highway 17
Unit 250
Murrells Inlet, SC 29576
Phone (843) 299-1721

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

2615 Woodruff Rd
Ste 400
Simpsonville, SC 29681
Phone (864) 537-5016

Interoperability endpoints

  • Direct secure messaging: dale.gallo.p1@direct.capefearortho.nextgenshare.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1003358532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DR STE 802",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142572",
            "telephone_number": "910-484-2171",
            "fax_number": "910-484-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DR STE 802",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142572",
            "telephone_number": "910-484-2171",
            "fax_number": "910-484-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "DALE",
        "middle_name": "ANTHONY",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8398",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.