Jessica Dale, DPT
Individual provider Active NPI Physical Therapist · Grayson, KY
NPI 1962993576 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1962993576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 007379 (KY)
- Practice address
- 144 S Carol Malone Blvd
Grayson, KY 41143-1352 - Phone
- (606) 474-7649
- Fax
- (606) 474-0855
- NPI assigned
- May 21, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Generations R.C., Inc.
Mobile Therapy Services
Practice addresses (Care Compare)
13 Kanawha Blvd W
Suite 300
Charleston, WV 25302-2350
Phone (304) 757-2500
144 S Carol Malone Blvd
Grayson, KY 41143-1352
Phone (606) 474-7649
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY, WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180719002657 | KY | Practitioner - Physical Therapist in Private Practice | 5294082343 | Reassigns benefits to 1 organization |
| I20180813000000 | WV | Practitioner - Physical Therapist in Private Practice | 5294082343 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Generations R.C., Inc | Physical Therapist | Current | Accepting new patients |
| Mobile Therapy Services | Physical Therapist | Current |
Accepting new patients |
| Generations R.C., Inc. | Physical Therapist | Current |
Accepting new patients |
| Generations R.C., Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
144 S Carol Malone Blvd
Grayson, KY 41143
Phone (606) 474-7649
7966 US Route 60
Barboursville, WV 25504
Phone (304) 733-9560
100 Marshall St N
Ste 2
Benwood, WV 26031
Phone (304) 218-2300
13 Kanawha Blvd W
Ste 300
Charleston, WV 25302
Phone (304) 757-2500
3705 Teays Valley Rd
Ste 100
Hurricane, WV 25526
Phone (304) 757-2500
305 E Main St
Milton, WV 25541
Phone (304) 743-6995
4002 40th St
Nitro, WV 25143
Phone (304) 757-2500
12510 Winfield Rd
Winfield, WV 25213
Phone (304) 586-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003964 | WV | |
| Physical Therapist | 225100000X | 007379 | KY | Yes |
Addresses
Primary practice location
144 S Carol Malone Blvd
Grayson, KY 41143-1352
Mailing address
144 S Carol Malone Blvd
Grayson, KY 41143-1352
Phone (606) 474-7649
Other practice location 1
3552 US Route 60 E
Barboursville, WV 25504-1639
Phone (304) 733-9560
Other providers in Grayson, KY
- Rebecca Lea Copeland
- Core Health Centers of Grayson
- Aimee Louise Cover
- Jeffrey Joseph Curley
- Nathan Curnutte
- Tommy Dearfield Jr.
- Barbara Dickerson
- Diversicare Leasing Corp.
- Tara Nicole Dollar
- Meagan Rhea Doyle
All providers in Grayson, KY · Physical Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.