Active NPI
Kimberly Dache Dale, DOT
- Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1659682326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056008963
- Practice address
- 515 N Jefferson Ave
Saint Louis, MO 63103-3000 - Phone
- (314) 652-4100
- NPI assigned
- Jun 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056008963 | IL | Primary |
Addresses
Primary practice location
515 N Jefferson Ave
Saint Louis, MO 63103-3000
Mailing address
620 Johnson Hill Rd
Apt. B
Collinsville, IL 62234-6039
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056008963 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1659682326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHNSON HILL RD",
"address_2": "APT. B",
"city": "COLLINSVILLE",
"state": "IL",
"postal_code": "622346039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N JEFFERSON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631033000",
"telephone_number": "314-652-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "KIMBERLY",
"middle_name": "DACHE",
"name_prefix": "Dr.",
"credential": "DOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-28",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056008963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.