Kelly A Dale, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN665150 Issued in CA

Practice address

2825 E Barnett Rd
Medford, OR 97504-8332

Phone

(541) 789-7000

Fax

(503) 220-3929

NPI assigned

Jul 27, 2007

Last updated

Sep 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Immediate Care, LLCGroup PAC ID 7618876723, 36 clinicians

AsanteGroup PAC ID 0547177321, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairchild Medical Center Hospital, Yreka, CA, CCN 051316
• Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment Care Compare group NPD
• Valley Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Medford, OR
  • NPI 1982709226
  Medicare reassignment Care Compare group NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Medicare reassignment NPD
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment NPD
• Asante

  dba Heimann Cancer Center

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  Care Compare affiliation

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1245420074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010227",
            "telephone_number": "541-789-5516",
            "fax_number": "541-789-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000",
            "fax_number": "503-220-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN665150",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200850060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie D'Mello, PT
• David Russell Dahl, L.D.
• Amy Dahla, LPC, LPCC
• Sarah Ladonna Dahling
• Darin Dale, LCSW
• Victoria Leigh Dalzell, BSN
• Aaron D Dam, M.D.
• Cassandra Damon
• Jennifer Lee Damon, PSS
• Kaeli Damon

• Family Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.