Individual provider Active NPI

Dodie Gordon Daniels, NP

  • Family Nurse Practitioner
  • Elizabeth, LA
National Provider Identifier
1033699525
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10136 Issued in LA
Practice address
504 W. Main Street
Elizabeth, LA 70638
Phone
(318) 634-5475
Fax
(318) 634-5476
NPI assigned
Aug 15, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10136 LA Primary

Addresses

Primary practice location

504 W. Main Street
Elizabeth, LA 70638

Mailing address

PO Box 629
Oakdale, LA 71463-0629
Phone (318) 634-5475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190107000541 LA Practitioner - Nurse Practitioner 0143566554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CLHG-Oakdale LLCGroup PAC ID 1355623943, 37 clinicians

Practice addresses (Care Compare)

105 Hospital Dr
Oakdale, LA 71463-3034
Phone (318) 335-4320

130 Hospital Dr
Oakdale, LA 71463-3035
Phone (318) 315-7093

400 E 6TH Ave
Oakdale, LA 71463-2628
Phone (318) 315-7093

PO Box
Suite 629
Oakdale, LA 71463

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10136LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Oakdale LLC CurrentSince Sep 8, 2018 Accepting new patients
CLHG-Oakdale LLC CurrentSince Sep 8, 2018 Accepting new patients

Locations

105 Hospital Dr
Oakdale, LA 71463
Phone (318) 335-4320

130 Hospital Dr
Oakdale, LA 71463
Phone (318) 215-3084

1884 Highway 165 S
Oakdale, LA 71463
Phone (318) 335-3501

400 E 6th Ave
Oakdale, LA 71463
Phone (318) 335-3501

Interoperability endpoints

  • Direct secure messaging: dodie.daniels.1@29237.direct.athenahealth.com
  • Direct secure messaging: dodie.daniels@clhgofhc.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1033699525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "OAKDALE",
            "state": "LA",
            "postal_code": "714630629",
            "telephone_number": "318-634-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W. MAIN STREET",
            "city": "ELIZABETH",
            "state": "LA",
            "postal_code": "70638",
            "telephone_number": "318-634-5475",
            "fax_number": "318-634-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "DODIE",
        "middle_name": "GORDON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP10136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, LA

Sources for this page

Verify at the official NPI Registry.