Active NPI
Dale Thomas Mericle, MD
- Family Medicine Physician
- Reno, NV
National Provider Identifier
1306047477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C29424
- Practice address
- 4425 Primavera Ave
Reno, NV 89502-5374 - Phone
- (775) 828-4941
- Fax
- (206) 339-6079
- NPI assigned
- May 29, 2007
- 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 | C29424 | CA | Primary |
Addresses
Primary practice location
4425 Primavera Ave
Reno, NV 89502-5374
Mailing address
4425 Primavera Ave
Reno, NV 89502-5374
Phone (775) 828-4941
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C29424 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1306047477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 PRIMAVERA AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895025374",
"telephone_number": "775-828-4941",
"fax_number": "206-339-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 PRIMAVERA AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895025374",
"telephone_number": "775-828-4941",
"fax_number": "206-339-6079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERICLE",
"first_name": "DALE",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C29424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.