Individual provider Active NPI

Josh Alan Dale, RD, LD

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1093096331
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2006038467 Issued in MO
Practice address
3117 Olive St
Saint Louis, MO 63103-1212
Phone
(314) 652-3663
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2006038467 MO Primary
Registered Dietitian 133V00000X 164004815 IL

Addresses

Primary practice location

3117 Olive St
Saint Louis, MO 63103-1212

Mailing address

8 Westglen CT
Saint Peters, MO 63376-4704
Phone (636) 373-2196

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
164004815ILMDRegistered Dietitian
2006038467MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1093096331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WESTGLEN CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764704",
            "telephone_number": "636-373-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031212",
            "telephone_number": "314-652-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "JOSH",
        "middle_name": "ALAN",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2006038467",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.