Active NPI
Andrew McLean Dale, MD
- Diagnostic Radiology Physician
- Winston-Salem, NC
National Provider Identifier
1376573816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 39410
- Practice address
- 3155 Maplewood Ave
Winston-Salem, NC 27103 - Phone
- (336) 794-4372
- Fax
- (336) 659-2379
- NPI assigned
- Jul 3, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 39410 | ND | Primary |
Addresses
Primary practice location
3155 Maplewood Ave
Winston-Salem, NC 27103
Mailing address
3010 Trenwest Dr
Winston Salem, NC 27103-3208
Phone (336) 970-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8926586 | Medicaid | NC |
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 |
|---|---|---|---|
| 39410 | ND | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation Health Systems Corp. | Past | Accepting new patients | |
| Triad Radiology Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1053379941
-
- Vascular & Interventional Radiology Physician
- Winston Salem, NC
- NPI 1447368659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299456000000",
"number": "1376573816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 TRENWEST DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271033208",
"telephone_number": "336-970-5000",
"fax_number": "336-970-5298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3155 MAPLEWOOD AVE",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-794-4372",
"fax_number": "336-659-2379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "ANDREW",
"middle_name": "MCLEAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2011-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ND",
"license": "39410",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8926586",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.