Mary Louise Dale, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50000225 Issued in OH

Practice address

3694 Starrs Centre Dr
Canfield, OH 44406-9514

Phone

(330) 702-1310

Fax

(330) 702-1344

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19596/brand/1/csg/1/fhir/r4

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.

• Triad Health Services, LLC

  • Plastic Surgery Physician
  • Youngstown, OH
  • NPI 1588925457
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487601753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3694 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069514",
            "telephone_number": "330-702-1310",
            "fax_number": "330-702-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3694 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069514",
            "telephone_number": "330-702-1310",
            "fax_number": "330-702-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50000225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Cross, DPT
• Bethany A Crouch
• Sharon Cuchacovich Francos, MFT-T
• Cheri Cutlip, AGPCNP
• Cheryl Lynn Dailey
• Darlene Dalvin, PH.D.
• Robert Daniluk, CRNA
• Daniel S Dankovich, DC
• Kandis Daroski, DPT
• Christina M Dascenzo, R.PH., PHARM.D.

• Medical Physician Assistant in Canfield, OH
• Providers in Canfield, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.