Avery Lynette Dale, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

24777 Issued in TN

Practice address

65 Germantown CT Ste 402
Cordova, TN 38018-4275

Phone

(901) 752-4900

Fax

(901) 752-4902

NPI assigned

Aug 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vanderbilt University

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1285659706
  NPD (past)

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1154809796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 GERMANTOWN CT STE 402",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184275",
            "telephone_number": "901-752-4900",
            "fax_number": "901-752-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 GERMANTOWN CT STE 402",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184275",
            "telephone_number": "901-752-4900",
            "fax_number": "901-752-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "AVERY",
        "middle_name": "LYNETTE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "118022",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "24777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "118022",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE PRACTICE REGISTERED NURSE",
            "identifier": "24777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy V Curtis, PHARMD
• D & W Supreme Transportation LLC
• D&E Quality Nemt, LLC
• David Dabbs, ATC
• Leigh Erin Daigle, M.D.
• Julie Anne Daniels, MOT, OTR/L
• Nneka Daniels
• James Edward Davenport Jr.
• David H. Crowder, D.D.S. P.C.
• David W. Smith, DDS PLLC

• Psychiatric/Mental Health Nurse Practitioner in Cordova, TN
• Providers in Cordova, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.