NPIMap

Organization Active NPI

Dale Medical Center

Doing business as Oliver W Crawford Jr

  • Internal Medicine Physician
  • Ozark, AL
National Provider Identifier
1659533206
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28100 Issued in AL
Legal business name
DALE MEDICAL CENTER
Doing business as
Oliver W Crawford Jr
Practice address
218 Hospital Ave
Suite B
Ozark, AL 36360-2064
Phone
(334) 774-5864
Fax
(334) 774-1437
NPI assigned
Jun 25, 2008
Last updated
Apr 15, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
DALE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 28100 AL Primary

Addresses

Primary practice location

218 Hospital Ave
Suite B
Ozark, AL 36360-2064

Mailing address

PO Box 863
Ozark, AL 36361-0863
Phone (334) 774-5864

Other names 1

  • Oliver W Crawford Jr Doing business as

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
Dale Medical Center DME13 organizations share this tax ID, including this one
Part of
Dale Medical Center DME

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the 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": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1659533206",
    "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": "334-774-5864",
            "fax_number": "334-774-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 HOSPITAL AVE",
            "address_2": "SUITE B",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363602064",
            "telephone_number": "334-774-5864",
            "fax_number": "334-774-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DALE MEDICAL CENTER",
        "enumeration_date": "2008-06-25",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-774-2601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "28100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oliver W Crawford Jr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 15, 2010; 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.