Active NPI
Stephen Dale, DPT
- Physical Therapist
- Brownsburg, IN
National Provider Identifier
1346643863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05011461A
- Practice address
- 590 Pit Rd
Brownsburg, IN 46112-7830 - Phone
- (317) 415-6040
- NPI assigned
- Sep 29, 2014
- Last updated
- Dec 5, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05011461A | IN | Primary |
Addresses
Primary practice location
590 Pit Rd
Brownsburg, IN 46112-7830
Mailing address
590 Pit Rd
Brownsburg, IN 46112-7830
Other practice location 1
9885 E 116th St Ste 400
Fishers, IN 46037-9243
Phone (317) 813-4770
Other practice location 2
5695 Pebble Village Lane
Noblesville, IN 46062
Phone (317) 565-1310
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05011461A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Performance and Rehab LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Carmel, IN
- NPI 1295680296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1346643863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 PIT RD",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461127830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 PIT RD",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461127830",
"telephone_number": "317-415-6040"
}
],
"practiceLocations": [
{
"address_1": "9885 E 116th St Ste 400",
"address_purpose": "LOCATION",
"city": "Fishers",
"state": "IN",
"postal_code": "460379243",
"country_code": "US",
"telephone_number": "317-813-4770",
"fax_number": "317-813-4771",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5695 Pebble Village Lane",
"address_purpose": "LOCATION",
"city": "Noblesville",
"state": "IN",
"postal_code": "46062",
"country_code": "US",
"telephone_number": "317-565-1310",
"fax_number": "317-565-1311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALE",
"first_name": "STEPHEN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-29",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05011461A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.