Individual provider Active NPI

Bradley James Dale, PT

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1689622664
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8324 Issued in GA
Practice address
61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176
Phone
(770) 422-3290
Fax
(770) 422-0287
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8324 GA Primary

Addresses

Primary practice location

61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176

Mailing address

61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176
Phone (770) 422-3290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100309000190 GA Practitioner - Physical Therapist in Private Practice 2567507049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

3698 Largent NW Way
Ste103
Marietta, GA 30064-5923
Phone (678) 354-2883

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8324GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Oct 4, 2021 Accepting new patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Oct 4, 2021 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Georgia Pro Motion Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients

Locations

2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

61 Whitcher St NE
Ste 1150
Marietta, GA 30060
Phone (678) 594-4250

790 Church St NE
Ste 300
Marietta, GA 30060
Phone (770) 422-3290

3698 Largent Way NW
Ste 103
Marietta, GA 30064
Phone (678) 354-2883

61 Whitcher St NE
Ste 1100
Marietta, GA 30060
Phone (615) 686-2262

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

Interoperability endpoints

  • Direct secure messaging: bradley.dale.1@15749.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1689622664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 1100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 1100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "8324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.