Individual provider Active NPI

Dale Vance, FNP

  • Family Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1023643194
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN269964 Issued in GA
Practice address
223 N Houston Rd
Ste 140E
Warner Robins, GA 31093
Phone
(478) 975-6880
Fax
(478) 975-6869
NPI assigned
Mar 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN269964 GA Primary

Addresses

Primary practice location

223 N Houston Rd
Ste 140E
Warner Robins, GA 31093

Mailing address

223 N Houston Rd
Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200821002975 GA Practitioner - Nurse Practitioner 1254757115 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN269964GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Primary Care Physicians, LLC CurrentSince Mar 29, 2023 Accepting new patients
Houston Primary Care Physicians LLC CurrentSince Mar 29, 2023 Accepting new patients
Internal Medicine & Geriatrics of Houston, LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

201 Stillwater Cir
Bonaire, GA 31005
Phone (478) 328-9690

233 N Houston Rd
Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880

1743 Watson Blvd
Ste A
Warner Robins, GA 31093
Phone (478) 328-9690

Organizations & group practices 3

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1023643194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N HOUSTON RD",
            "address_2": "STE 140E",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31093",
            "telephone_number": "478-975-6880",
            "fax_number": "478-975-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N HOUSTON RD",
            "address_2": "STE 140E",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31093",
            "telephone_number": "478-975-6880",
            "fax_number": "478-975-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "DALE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2023-05-08",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN269964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.