Crystal Dale (NPI# 1245612654, PAC ID# 9133420987) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1245612654 |
| PAC ID by PECOS | 9133420987 |
| Professional Enrollment ID | I20151221000625 |
| Full Name | Crystal Dale |
| Organization Legal Name | HEART CENTER LLC |
| Address |
200 S Enota Dr Ne Gainesville GA 30501-3466 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4183848062 |
| Number of Group Practice Members | 93 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110029 | NORTHEAST GEORGIA MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 1400 River Pl, Braselton, GA 30517-5600 | 7708488000 | HEART CENTER LLC |
| 1404 River Pl, Braselton, GA 30517-5600 | HEART CENTER LLC | |
| 200 S Enota Dr Ne, Gainesville, GA 30501-3466 | HEART CENTER LLC | |
| 743 Spring St Ne, Gainesville, GA 30501-3715 | 7702199000 | HEART CENTER LLC |
| Organization Legal Name | HEART CENTER LLC |
| Physicians | 87 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anela D Pearson | Nurse Practitioner | Heart Center LLC | 743 Spring St Ne, Gainesville, GA 30501-3715 |
| Alok Gambhir | Cardiac Electrophysiology | Heart Center LLC | 900 Sanders Rd, Suite A, Cumming, GA 30041-5960 |
| Heather M Tillery | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| James Varnell Jr. | Cardiovascular Disease (cardiology) | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Veronica Eberhart | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| Michael D Wood | Physician Assistant | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| Keith D Adkins | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Nima Ghasemzadeh | Interventional Cardiology | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Shelia H Bradshaw | Nurse Practitioner | Heart Center LLC | 743 Spring St Ne, Gainesville, GA 30501-3715 |
| Zaid Houfdhi Said | Cardiovascular Disease (cardiology) | Heart Center LLC | 200 S Enota Dr Ne, Suite 100, Gainesville, GA 30501-3466 |
| Street Address |
200 S ENOTA DR NE |
| City | GAINESVILLE |
| State | GA |
| Zip | 30501-3466 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heather M Tillery | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| James Varnell Jr. | Cardiovascular Disease (cardiology) | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Veronica Eberhart | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| Michael D Wood | Physician Assistant | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| Keith D Adkins | Nurse Practitioner | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Nima Ghasemzadeh | Interventional Cardiology | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Zaid Houfdhi Said | Cardiovascular Disease (cardiology) | Heart Center LLC | 200 S Enota Dr Ne, Suite 100, Gainesville, GA 30501-3466 |
| Tram B Contreras | Physician Assistant | Heart Center LLC | 200 S Enota Dr Ne, Gainesville, GA 30501-3466 |
| Pavani Kolakalapudi | Cardiovascular Disease (cardiology) | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Oghenerukevwe Odiete | Interventional Cardiology | Heart Center LLC | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3466 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leroy W Robinson Iii | Optometry | Lanier Eye Associates, LLC | 625 S Enota Nedr, Gainesville, GA 30501 |
| William C Ackerman | Ophthalmology | Lanier Eye Associates, LLC | 625 S Enota Nedr, Gainesville, GA 30501 |
| Julius Nathaniel Skeete | Optometry | 150 Pearl Nix Pkwy, D3a, Gainesville, GA 30501-0001 | |
| William T Crews | Chiropractic | 1864 Thompson Bridge Rd, Gainesville, GA 30501-1119 | |
| Julia H Strong | Clinical Social Worker | 1709 B Cleveland Hwy, Gainesville, GA 30501-1353 | |
| Kathryn W. Dudas | Family Medicine | Northeast Georgia Physicians Group Inc | 1856 Thompson Bridge Rd, Suite 14, Gainesville, GA 30501-1620 |
| Yesenia Delosangeles | Clinical Social Worker | Northeast Georgia Physicians Group Inc | 1856 Thompson Bridge Rd, Suite 14, Gainesville, GA 30501-1620 |
| Christy M Wagner | Family Medicine | Northeast Georgia Physicians Group Inc | 1856 Thompson Bridge Rd, Suite 14, Gainesville, GA 30501-1620 |
| Catherine E Norton | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 1856 Thompson Bridge Rd, Suite 14, Gainesville, GA 30501-1620 |
| Jennifer A Roark | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 1856 Thompson Bridge Rd, Suite 14, Gainesville, GA 30501-1620 |
| Find all physicians in zip 30501 | |||
| City | GAINESVILLE |
| Zip Code | 30501 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GAINESVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Crystal Dale.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.