Active NPI
Stephanie Dale, PTA
- Physical Therapy Assistant
- Mesa, AZ
National Provider Identifier
1821850819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 014362
- Practice address
- 10861 E Baseline Rd Ste A105
Mesa, AZ 85209-7921 - Phone
- (602) 775-0999
- NPI assigned
- Jan 25, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 014362 | AZ | Primary |
Addresses
Primary practice location
10861 E Baseline Rd Ste A105
Mesa, AZ 85209-7921
Mailing address
275 W Juniper Ave Apt 2122
Gilbert, AZ 85233-3931
Phone (602) 775-0999
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 |
|---|---|---|---|
| 014362 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1821850819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W JUNIPER AVE APT 2122",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852333931",
"telephone_number": "602-775-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10861 E BASELINE RD STE A105",
"city": "MESA",
"state": "AZ",
"postal_code": "852097921",
"telephone_number": "602-775-0999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "STEPHANIE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-25",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "014362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.