Individual provider Active NPI

Tanyonisha Rokaye Dale

  • Registered Nurse
  • Jackson, MS
National Provider Identifier
1154767309
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R856193 Issued in MS
Practice address
411 Sharon Hills Dr
Jackson, MS 39212-2234
Phone
(601) 918-6275
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R856193 MS Primary
Critical Care Medicine Registered Nurse 163WC0200X R856193 MS

Addresses

Primary practice location

411 Sharon Hills Dr
Jackson, MS 39212-2234

Mailing address

411 Sharon Hills Dr
Jackson, MS 39212-2234
Phone (601) 918-6275

Other names 1

  • Nikki Dale Other name

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
R856193MSMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1154767309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SHARON HILLS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392122234",
            "telephone_number": "601-918-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SHARON HILLS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392122234",
            "telephone_number": "601-918-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "TANYONISHA",
        "middle_name": "ROKAYE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R856193",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MS",
            "license": "R856193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "DALE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.