Reynold J Dahl, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

54988 Issued in MA

Practice address

100 Commerce Dr
Northbridge, MA 01534-1415

Phone

(508) 234-6311

Fax

(508) 634-4215

NPI assigned

Jul 12, 2006

Last updated

Dec 12, 2014By the provider in NPPES

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 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1932134202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 INDUSTRIAL RD",
            "address_2": "SUITE 5",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573588",
            "telephone_number": "508-473-1480",
            "fax_number": "508-473-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMERCE DR",
            "city": "NORTHBRIDGE",
            "state": "MA",
            "postal_code": "015341415",
            "telephone_number": "508-234-6311",
            "fax_number": "508-634-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "REYNOLD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "54988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001130",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J04872",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly E Cain, MD
• Angela M Casado-Diaz, MD
• Kimberlee Cashin, N.P.
• Christina Cronin Licsw LLC
• Lynn Conroy
• Kelly Ann Decaire, M.A CCC-SLP
• Chantal G. Dewey, M.D.
• Jennifer Gartman, MD
• Christine Goodwin
• Patrick Daniel Hazard, PA-C

• Family Medicine Physician in Northbridge, MA
• Providers in Northbridge, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.