NPIMap

Organization Active NPI

Dale Medical Center

Doing business as Senior Therapeutic Health

  • Psychiatric Hospital Unit
  • Ozark, AL
National Provider Identifier
1366511156
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
11793 Issued in AL
Legal business name
DALE MEDICAL CENTER
Doing business as
Senior Therapeutic Health
Practice address
126 Hospital Ave
Ozark, AL 36360-2018
Phone
(334) 774-2601
NPI assigned
Nov 7, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Authorized official

Name
Mr. Vernon L Johnson
Title
Chief Executive Officer
Phone
(334) 774-2601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 11793 AL Primary

Addresses

Primary practice location

126 Hospital Ave
Ozark, AL 36360-2018

Mailing address

126 Hospital Ave
Ozark, AL 36360-2018
Phone (334) 774-2601

Other names 1

  • SENIOR THERAPEUTIC HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111117000634 AL Part A Provider - Hospital 3476466327 Practice locations: Ozark, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366511156. Details of each certification follow.

Hospital certification: CCN 01S021

Legal name
DALE MEDICAL CENTER
Doing business as
DALE MEDICAL CENTER GERIATRIC PSYCH
Organization structure
OtherNon-profit
Incorporated
Mar 20, 2007 in AL
Enrollment address
126 Hospital Avenue
Ozark, AL 36360-2018
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Richard S Hammockmd Dba Dale Medical Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vernon Johnson Individual Corporate OfficerCeo Apr 23, 2023
W-2 Managing Employee Oct 1, 2002
Richard Wright Individual Corporate OfficerCfo Nov 1, 2017
Miach McNab Individual Corporate DirectorBoard Chairman Apr 21, 2023

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dale Medical CenterOzark, AL, CCN 01U021 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 31, 2017
Jan 15, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Dale Medical Center
    • Medicare Defined Swing Bed Hospital Unit
    • Ozark, AL
    • NPI 1215479357

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1366511156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 HOSPITAL AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363602018",
            "telephone_number": "334-774-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 HOSPITAL AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363602018",
            "telephone_number": "334-774-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "334-774-2601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AL",
            "license": "11793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENIOR THERAPEUTIC HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ozark, AL

Sources for this page

Verify at the official NPI Registry.