Active NPI
Sunny R McDaniel, FNP-C
- Family Nurse Practitioner
- Covington, LA
National Provider Identifier
1003137597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP06195
- Practice address
- 120 Innwood Dr
Covington, LA 70433-9123 - Phone
- (985) 892-3225
- Fax
- (985) 892-7677
- NPI assigned
- Jun 18, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP06195 | LA | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | AP06195 | LA |
Addresses
Primary practice location
120 Innwood Dr
Covington, LA 70433-9123
Mailing address
1055 David Dr.
Morgan City, LA 70380-1300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2119222 | Medicaid | LA | |
| 60110926 | Other | LA | LACARE |
| 01626891 | Other | LA | AMERIGROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP06195 | LA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strawberry Patch Pediatrics LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Ponchatoula, LA
- NPI 1346895638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1003137597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 DAVID DR.",
"city": "MORGAN CITY",
"state": "LA",
"postal_code": "703801300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 INNWOOD DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704339123",
"telephone_number": "985-892-3225",
"fax_number": "985-892-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "SUNNY",
"middle_name": "R",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-18",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP06195",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "LA",
"license": "AP06195",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2119222",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LACARE",
"identifier": "60110926",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "01626891",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.