MR. DALE E MORTENSON (NPI# 1629149612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629149612 |
| Entity Type | Individual |
| Full Name | MR. DALE E MORTENSON |
| Credential | DC |
| Practice Address |
1101 Ohio Ave Lynn Haven FL 32444-2554 |
| Mailing Address |
Pob 1960 Lynn Haven FL 32444-6960 |
| Practice Telephone | 8502656163 |
| Practice Fax Number | 8502654059 |
| Mailing Telephone | 8502656163 |
| Mailing Fax Number | 8502654059 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2015-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH4624 | FL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 70497 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699984195 | Dale Norris Mortenson | Chiropractor | 2041 Polk St Ste A, San Francisco, CA 94109-2549 | 2007-05-21 |
| 1588766265 | Dale Martin Mortenson | Social Worker | 376 W End Ave, Suite #48, Long Branch, NJ 07740-5259 | 2006-09-02 |
| 1801949722 | Dale R Mortenson | Surgery | 400 13th Ave S, Suite 102 Great Falls Surgical Associates, Great Falls, MT 59405-4300 | 2007-01-22 |
| Street Address |
1101 OHIO AVE |
| City | LYNN HAVEN |
| State | FL |
| Zip Code | 32444-2554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952544413 | Dale E Mortenson Dc Pa | Chiropractor | 1101 Ohio Ave, Lynn Haven, FL 32444-2554 | 2009-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508404062 | Anthony Briel | Military Health Care Provider | 305 S Crag Road, Panama City, FL 32444 | 2019-12-16 |
| 1487155149 | Hope Abigail Koller | Behavior Technician | 2007 Brenda Circle, Lynn Haven, FL 32444 | 2018-02-27 |
| 1871849836 | Kristopher D Isenberg | Physical Therapy Assistant | 307 Geralo Lane, Lynn Haven, FL 32444 | 2012-07-27 |
| 1699067942 | Nation's Best Family Health Care Pllc | Family Medicine | 817 Ohio Avenue, Lynn Haven, FL 32444 | 2011-05-04 |
| 1992989883 | Medstop Pl LLC | Family Medicine | 3003 State Highway 77, Suite A, Lynn Haven, FL 32444 | 2007-12-27 |
| 1407062508 | Dianne Basford Ray | Pharmacist | 1812 Hwy 77 So, Unit #119, Lynn Haven, FL 32444 | 2007-05-15 |
| 1467679142 | St. Andrew Bay Center, Inc. | Day Training, Developmentally Disabled Services | 1804 Carolina Avenue, Lynn Haven, FL 32444 | 2007-04-20 |
| 1003030412 | Velma L Murphy | Case Manager/Care Coordinator | 1312 Virginia Avenue, Lynn Haven, FL 32444 | 2007-04-13 |
| 1437285087 | Fred William Werner | Pharmacist | 1812 Hwy 77 South, Lynn Haven, FL 32444 | 2007-02-26 |
| 1689746588 | Shawn Dey Walker | Massage Therapist | 1405 Wyoming Ave, Lynn Haven, FL 32444 | 2006-11-15 |
| Find all providers in zip 32444 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952544413 | Dale E Mortenson Dc Pa | Chiropractor | 1101 Ohio Ave, Lynn Haven, FL 32444-2554 | 2009-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659366 | Mcclure Family and Sports | Chiropractor | 5420 Land O Lakes Blvd Ste 105, Land O Lakes, FL 34639-3401 | 2020-11-06 |
| 1922609379 | Parker Elizabeth Lee | Chiropractor | 196 37th Ave N, Saint Petersburg, FL 33704-1414 | 2020-11-03 |
| 1356942940 | Michelle George | Chiropractor | 840 N Cocoa Blvd Ste A, Cocoa, FL 32922-7590 | 2020-11-02 |
| 1124629647 | Travis Edward Kerner | Chiropractor | 18505 Nw 75th Pl Ste 117, Hialeah, FL 33015-2961 | 2020-11-02 |
| 1720688641 | Desiree Bethel | Chiropractor | 551 Ne 174th St, North Miami Beach, FL 33162-1945 | 2020-10-29 |
| 1255931010 | Spinewell Inc | Chiropractor | 650 Central Ave Ste 3, Sarasota, FL 34236-4090 | 2020-10-29 |
| 1982203543 | William Jesse Naftel | Chiropractor | 981 Highway 98 E Ste 9, Destin, FL 32541-2588 | 2020-10-23 |
| 1679172548 | Jacksonville Chiropractic Rehab and Wellness Center | Chiropractor | 7908 Blanding Boulevard, Suite #4, Jacksonville, FL 32244-7564 | 2020-10-22 |
| 1588263560 | Chiropractic Spine and Injury Pa | Chiropractor | 158 Tuskawilla Rd Ste 1308, Winter Springs, FL 32708-2805 | 2020-10-21 |
| 1588263867 | Orchid Island Chiropractic, LLC | Chiropractor | 9613 N Us Highway 1, Sebastian, FL 32958-6363 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
| City | LYNN HAVEN |
| Zip Code | 32444 |
Please comment or provide details below to improve the information on MR. DALE E MORTENSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.