Individual provider Active NPI

Dale N Fine, MD

  • Emergency Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1619963691
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00014761 Issued in WA
Practice address
6411 E Crocus Dr
Scottsdale, AZ 85254-3353
Phone
(480) 208-9408
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00014761 WA
Emergency Medicine Physician 207P00000X MD00014761 WA Primary

Addresses

Primary practice location

6411 E Crocus Dr
Scottsdale, AZ 85254-3353

Mailing address

6411 E Crocus Dr
Scottsdale, AZ 85254-3353
Phone (480) 208-9408

Other identifiers 1

IdentifierTypeStateIssuer
8345290MedicaidWA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00014761WAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1619963691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 E CROCUS DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543353",
            "telephone_number": "480-208-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 E CROCUS DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543353",
            "telephone_number": "480-208-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "DALE",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00014761",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00014761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8345290",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.