Dale Green, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19251 Issued in CA

Practice address

3400 Calloway Dr Ste 603
Bakersfield, CA 93312-2514

Phone

(661) 377-1700

Fax

(661) 616-9199

NPI assigned

Jul 24, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Terrio Therapy-Fitness IncGroup PAC ID 8628059805, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Terrio Therapy-Fitness, Inc.

  • Physical Therapist
  • Bakersfield, CA
  • NPI 1841267689
  Medicare reassignment Care Compare group NPD
• Bakersfield Memorial Hospital

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1083844005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR STE 603",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122514",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR STE 603",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122514",
            "telephone_number": "661-377-1700",
            "fax_number": "661-616-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DALE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT19251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "CK583Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Paula Graziano, O.D.
• Greater Bakersfield Dialysis Center LLC
• Greater la Neurosurgery and Pain Management
• Justin Greemore
• Ashley Michele Green
• Deanna Green
• Ellen Patricia Green, SLP
• Michael Everett Green
• Ryan Tyson Green, D.C.
• Tina Linette Green, MS, LMFT

• Physical Therapist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.