Benjamin Dale, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA70 Issued in AL

Practice address

48 Medical Park Dr E Ste 354
Birmingham, AL 35235-3469

Phone

(866) 546-2124

Fax

(866) 546-2124

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Eastside Ventures, Inc.

  dba Cleveland Family Healthcare

  • Family Medicine Physician
  • Cleveland, AL
  • NPI 1609900406
  NPD (past)
• Jefferson Clinic, P.C.

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1124086509
  NPD (past)
• Simon-Williamson Clinic, P.C.

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1497702344
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1285664730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E STE 354",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353469",
            "telephone_number": "866-546-2124",
            "fax_number": "866-546-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E STE 354",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353469",
            "telephone_number": "866-546-2124",
            "fax_number": "866-546-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "BENJAMIN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA70",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000042307",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martina Dailey, LICSW
• Sharon M Dailey, MD
• Vanessa Dailey
• Valeria Laura Dal Zotto, M.D.
• Dale Brown MD PC
• Jillian Dale, ALC
• Lindsey Dale
• Joseph Thomas Daley, MD
• Lauren Victoria Daley, MD
• Quiawanna Dallas

• Medical Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.