NPIMap

Organization Active NPI

Dale Medical Center

  • Family Medicine Physician
  • Ozark, AL
National Provider Identifier
1821363524
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DALE MEDICAL CENTER
Practice address
320 White Ave
Ozark, AL 36360-0908
Phone
(334) 443-0400
Fax
(334) 443-0402
NPI assigned
Mar 13, 2012
Last updated
Mar 19, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
OZARK MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Mr. Brad Hull, CFO
Title
Cfo
Phone
(334) 774-2601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

320 White Ave
Ozark, AL 36360-0908

Mailing address

PO Box 863
Ozark, AL 36361-0863
Phone (334) 443-0400

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
Part of
Dong Lim Ji MD

Locations

320 White Ave
Ozark, AL 36360
Phone (334) 443-0400

Practitioners & affiliated clinicians

Practitioners 2

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": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1821363524",
    "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": "334-443-0400",
            "fax_number": "334-443-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WHITE AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363600908",
            "telephone_number": "334-443-0400",
            "fax_number": "334-443-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OZARK MEDICAL CLINIC",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-774-2601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 19, 2012; 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.