Active NPI
Dale Intihar, M.D.
- Family Medicine Physician
- Palm Coast, FL
National Provider Identifier
1164490199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME89456
- Practice address
- 309 Palm Coast Pkwy NE
Palm Coast, FL 32137-3886 - Phone
- (386) 445-7073
- Fax
- (386) 447-7092
- NPI assigned
- Mar 8, 2006
- Last updated
- Feb 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME89456 | FL | Primary |
Addresses
Primary practice location
309 Palm Coast Pkwy NE
Palm Coast, FL 32137-3886
Mailing address
PO Box 9671
Daytona Beach, FL 32120
Phone (386) 676-7130
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164490199 | Other | FL | TRICARE |
| 37624 | Other | FL | BCBS |
| ME89456 | Other | FL | VHN |
| P01034306 | Other | FL | RAILROAD |
| 268950200 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- daleintihar@fhcpfl.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1164490199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9671",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "32120",
"telephone_number": "386-676-7130",
"fax_number": "386-676-7125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 PALM COAST PKWY NE",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321373886",
"telephone_number": "386-445-7073",
"fax_number": "386-447-7092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTIHAR",
"first_name": "DALE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME89456",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1164490199",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "37624",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VHN",
"identifier": "ME89456",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P01034306",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "268950200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
- Inner Dynamics, LLC
- Inpatient Services of Florida PA
- Integrated Community Oncology Network LLC
- Integrative Acupuncture & Health Coaching LLC
- Intercoastal Neurology and Sleep Care Center PLLC
- Inverness Terra Senior Living of Palm Coast LLC
- Angelo Peter Ippolito, D.C.
- Ips of Palm Coast LLC
- Muhammad Fahair Iqbal, MD
- Michael Alan Isicoff, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.