Amber Maria Dale, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN245277 Issued in GA

Practice address

1561 McLendon Ave NE
Atlanta, GA 30307-2167

Phone

(678) 252-6919

Fax

(678) 737-1616

NPI assigned

Apr 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Amber Maria Forrest Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adale@landmarkhealth-direct.org
• Direct secure messaging: ms_adale8@landmarkhealth-direct.org
• FHIR API: https://fhir4.healow.com/fhir/r4/DJFHBD

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.

• Grady Memorial Hospital Corporation

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment NPD
• Health Education, Assessment and Leadership, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1831476399
  Medicare reassignment NPD
• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243
  Medicare reassignment NPD
• Vasaya Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
  • NPI 1013741685

  Family

  NPD Authorized official
• Grady Memorial Hospital Corporation

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Rome, GA
  • NPI 1861555450
  NPD
• Health Education Assessment and Leadership, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1700328309
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1831695170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GREENVILLE ST # 2345",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632789",
            "telephone_number": "678-830-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 MCLENDON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072167",
            "telephone_number": "678-252-6919",
            "fax_number": "678-737-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "AMBER",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN245277",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN245277",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN245277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "FORREST",
            "middle_name": "MARIA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Dakake
• Karina K Dalal
• Nupur Dalal, MD
• Som Dalamon
• Lori A Dalcour, NP
• Barbara Warshaw Dale, MSW, LCSW
• Kelsey Fortune Dalene, M.ED. CCC-SLP
• Tanicia Cheri Daley Jean Pierre, MD
• Daniel Seth Daley
• Tierra Lynne Daley, MSN, RN

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.