Active NPI
Samuel Jackson Dail, M.D.
- Family Medicine Physician
- New Bern, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2018-00120
- Practice address
- 1040 Medical Park Ave
New Bern, NC 28562 - Phone
- (252) 633-1678
- Fax
- (252) 633-1403
- NPI assigned
- May 22, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL38133 | SC | |
| Family Medicine Physician | 207Q00000X | 2018-00120 | NC | Primary |
Addresses
Primary practice location
1040 Medical Park Ave
New Bern, NC 28562
Mailing address
PO Box 12248
New Bern, NC 28561-2248
Phone (252) 514-6685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proactive Therapy of North Carolina IncSelect Physical Therapy Holdings Inc
Practice addresses (Care Compare)
1040 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 633-1678
2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818
2654 M L King Jr Blvd
New Bern, NC 28562-4238
Phone (252) 637-0093
Hospital & facility affiliations
- Centerwell Home Health
- Pruitthealth Home Health New Bern
- Carolina East Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018-00120 | NC | MD | Family Medicine Physician |
| LL38133 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Carolina Health Care PA | Family Medicine | Current | Accepting new patients |
| Coastal Carolina Health Care PA | Current | Accepting new patients | |
| Coastal Carolina Health Care PA | Family Medicine | Current | Accepting new patients |
Locations
1040 Medical Park Ave
New Bern, NC 28562
Phone (252) 633-1678
1020 Medical Park Ave
New Bern, NC 28562
Phone (252) 514-6685
Interoperability endpoints
- sdail27113@coastalcarolinahealthcenter.gardenplot.direct-ci.com
- samuel.dail.1@12142.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- New Bern, NC
- NPI 1750567970
-
- Family Medicine Physician
- New Bern, NC
- NPI 1366498297
-
- Family Medicine Physician
- Morehead City, NC
- NPI 1821959610
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Bern, NC
- NPI 1801852835
-
- Home Health Agency
- New Bern, NC
- NPI 1891197380
-
- Home Health Agency
- Pollocksville, NC
- NPI 1043243835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530576000000",
"number": "1255710331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12248",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285612248",
"telephone_number": "252-514-6685",
"fax_number": "252-514-2745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 MEDICAL PARK AVE",
"city": "NEW BERN",
"state": "NC",
"postal_code": "28562",
"telephone_number": "252-633-1678",
"fax_number": "252-633-1403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAIL",
"first_name": "SAMUEL",
"middle_name": "JACKSON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-22",
"last_updated": "2018-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL38133",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2018-00120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.