Individual provider Active NPI

Molly Elizabeth Dale, CRNP-FAMILY

  • Primary Care Nurse Practitioner
  • Deal Island, MD
National Provider Identifier
1427788470
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R222703 Issued in MD
Practice address
10120 Teal LN
Deal Island, MD 21821-1507
Phone
(410) 202-9941
NPI assigned
Jun 13, 2022
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R222703 MD Primary

Addresses

Primary practice location

10120 Teal LN
Deal Island, MD 21821-1507

Mailing address

10120 Teal LN
Deal Island, MD 21821-1507
Phone (410) 202-9941

Other identifiers 1

IdentifierTypeStateIssuer
R222703OtherMDCRNP-FAMILY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928000007 MD Practitioner - Nurse Practitioner 1456705268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sailwinds Medical, LLCGroup PAC ID 6901271717, 7 clinicians

Practice addresses (Care Compare)

1000 Goodwill Ave
Cambridge, MD 21613-2972
Phone (443) 972-4204

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R222703MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sailwinds Medical, LLC CurrentSince Jul 21, 2023 Accepting new patients
Sailwinds Medical, LLC Past Accepting new patients

Locations

1000 Goodwill Ave
Cambridge, MD 21613
Phone (443) 292-2233

560 Riverside Dr
#A103A106
Salisbury, MD 21801

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1427788470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 TEAL LN",
            "city": "DEAL ISLAND",
            "state": "MD",
            "postal_code": "218211507",
            "telephone_number": "410-202-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 TEAL LN",
            "city": "DEAL ISLAND",
            "state": "MD",
            "postal_code": "218211507",
            "telephone_number": "410-202-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "MOLLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "CRNP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R222703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP-FAMILY LICENSE",
            "identifier": "R222703",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.