Organization Active NPI

R.& D. Dale, M.D., Inc.

  • Psychiatry Physician
  • Rocky River, OH
National Provider Identifier
1801019229
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
R.& D. DALE, M.D., INC.
Practice address
20220 Center Ridge Rd
Suite 336
Rocky River, OH 44116-3501
Phone
(440) 356-4227
Fax
(440) 356-4231
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Diana A Dale, M.D.
Title
President
Phone
(440) 356-4227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X OH Primary

Addresses

Primary practice location

20220 Center Ridge Rd
Suite 336
Rocky River, OH 44116-3501

Mailing address

PO Box 451286
Westlake, OH 44145-0633
Phone (440) 356-4227

Other identifiers 2

IdentifierTypeStateIssuer
378568438005OtherOHMEDICAL MUTUAL
2261494MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111229000519 OH Part B Supplier - Clinic/Group Practice 5991971657 Receives reassigned benefits from 1 practitioner
Practice locations: Rocky River, OH

National Provider Directory

National Provider Directory

Locations

20575 Center Ridge Rd
Ste 311
Rocky River, OH 44116
Phone (440) 356-4227

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801019229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451286",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441450633",
            "telephone_number": "440-356-4227",
            "fax_number": "440-356-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20220 CENTER RIDGE RD",
            "address_2": "SUITE 336",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163501",
            "telephone_number": "440-356-4227",
            "fax_number": "440-356-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R.& D. DALE, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-356-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "378568438005",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2261494",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.