NPIMap

Organization Active NPI

Dale Medical Center

  • Family Medicine Physician
  • Ozark, AL
National Provider Identifier
1407051063
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DALE MEDICAL CENTER
Practice address
126 Hospital Ave
Ozark, AL 36360-2018
Phone
(334) 774-2601
Fax
(334) 443-0131
NPI assigned
Jun 15, 2007
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DALE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Mr. Vernon L. Johnson
Title
Ceo
Phone
(334) 774-2601

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X Primary
Cardiovascular Disease Physician 207RC0000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

126 Hospital Ave
Ozark, AL 36360-2018

Mailing address

PO Box 863
Ozark, AL 36361-0863
Phone (334) 443-1211

Other identifiers 1

IdentifierTypeStateIssuer
529924070MedicaidAL

Other names 1

  • Dale Medical Center Profee Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000202 AL Part B Supplier - Clinic/Group Practice 3476466327 Receives reassigned benefits from 47 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ozark, AL

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Dong Lim Ji MD13 organizations share this tax ID, including this one
Part of
Dong Lim Ji MD

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1407051063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363610863",
            "telephone_number": "334-443-1211",
            "fax_number": "334-443-0131"
        },
        {
            "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",
            "fax_number": "334-443-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DALE MEDICAL CENTER",
        "enumeration_date": "2007-06-15",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-774-2601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529924070",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dale Medical Center Profee",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ozark, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.