NPIMap

Organization Active NPI

Jodi Dale Inc

  • Early Intervention Provider Agency
  • Wellington, FL
National Provider Identifier
1568872935
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
OT0697 Issued in FL
Legal business name
JODI DALE INC
Practice address
4691 Manderly Dr
Wellington, FL 33449-7406
Phone
(561) 676-5198
Fax
(954) 343-6379
NPI assigned
May 6, 2014
Last updated
May 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Jodi BrunsvoldNPI 1073820502
Title
Pres
Phone
(561) 676-5198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X OT0697 FL Primary

Addresses

Primary practice location

4691 Manderly Dr
Wellington, FL 33449-7406

Mailing address

4691 Manderly Dr
Wellington, FL 33449-7406
Phone (561) 676-5198

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1568872935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4691 MANDERLY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334497406",
            "telephone_number": "561-676-5198",
            "fax_number": "954-343-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4691 MANDERLY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334497406",
            "telephone_number": "561-676-5198",
            "fax_number": "954-343-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI DALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "BRUNSVOLD",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "561-676-5198"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": "OT0697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.