Gregory L Dales

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP6962 Issued in CA

Practice address

6065 Highway 193
Georgetown, CA 95634

Phone

(530) 333-2555

Fax

(530) 333-2832

NPI assigned

Dec 14, 2005

Last updated

Apr 16, 2008By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1982689626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1807",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "956341807",
            "telephone_number": "530-333-2555",
            "fax_number": "530-333-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 HIGHWAY 193",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "95634",
            "telephone_number": "530-333-2555",
            "fax_number": "530-333-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALES",
        "first_name": "GREGORY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP6962",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN369163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Carley
• Rebecca Sue Clark
• Codyanne Marie Coombs, CLT
• Julie Crow-Petersen, NP
• Laura Ann Curry, MA, LMFT
• Beth A Gerkan, FNP
• Mark Lowell Greenmun, DDS
• Kenneth F. Hajek, DDS
• Keith P Harston, D.C.
• Daisy Klith, NP

• Nurse Practitioner in Georgetown, CA
• Providers in Georgetown, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.