Dale Merrell, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME41515 Issued in FL

Practice address

3 Shircliff Way
Suite 400
Jacksonville, FL 32204-4757

Phone

(904) 381-9393

Fax

(904) 381-9314

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1871585885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-3262",
            "fax_number": "904-265-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY",
            "address_2": "SUITE 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044757",
            "telephone_number": "904-381-9393",
            "fax_number": "904-381-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME41515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055680700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Meritt, DPM
• Gabriel Michael Meriwether
• Anna Merkel, DPT
• Justin Merkel, DPT
• Olivia Susanne Merkhofer
• Laura Elizabeth Merrell, M.A.
• Shanta Merrell
• Thelma Merrick
• Sarah L. Merriex
• Merrill Family Health Care PA

• Gastroenterology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.