Individual provider Active NPI

Julie Ann Dale, APRN

  • Acute Care Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1720491301
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2014017978 Issued in MO
Practice address
2031 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone
(636) 206-2690
Fax
(636) 206-2691
NPI assigned
Jun 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2014017978 MO Primary

Addresses

Primary practice location

2031 Zumbehl Rd
Saint Charles, MO 63303-2723

Mailing address

2031 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone (636) 206-2690

Other practice location 1

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 651-5836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140722000822 MO Practitioner - Nurse Practitioner 4284850645 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX - East Missouri Providers PCGroup PAC ID 8921294257, 5 clinicians

Practice addresses (Care Compare)

465 S Mount Auburn Rd
Suite 103
Cape Girardeau, MO 63703-4900
Phone (573) 335-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2014017978MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DRX - East Missouri Providers, P.C. CurrentSince Feb 1, 2025 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jun 16, 2014 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Sep 19, 2022 Accepting new patients
Mercy Southern Missouri Ambulatory Services LLC CurrentSince Jul 10, 2024 Accepting new patients
Lincoln County Hospital Past Accepting new patients

Locations

465 S Mount Auburn Rd
Ste 103
Cpe Girardeau, MO 63703
Phone (573) 335-2900

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

2031 Zumbehl Rd
Saint Charles, MO 63303
Phone (636) 206-2690

2150 W Republic Rd
Ste 112
Springfield, MO 65807
Phone (417) 986-1291

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

6055 N Main Street Rd
Webb City, MO 64870
Phone (417) 206-0400

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1720491301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032723",
            "telephone_number": "636-206-2690",
            "fax_number": "636-206-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032723",
            "telephone_number": "636-206-2690",
            "fax_number": "636-206-2691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Lacey St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637015230",
            "country_code": "US",
            "telephone_number": "573-651-5836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2014017978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.