Active NPI
Dudley Demaree McDaniel, MD
- Anesthesiology Physician
- Ojo Calinete, NM
National Provider Identifier
1073743316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD2005-0573
- Practice address
- 34020 US Highway 285
C/O Rancho de San Juan
Ojo Calinete, NM 87549 - Phone
- (505) 747-8711
- NPI assigned
- Jul 21, 2009
- Last updated
- Jul 21, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD2005-0573 | NM | Primary |
Addresses
Primary practice location
34020 US Highway 285
C/O Rancho de San Juan
Ojo Calinete, NM 87549
Mailing address
PO Box 1155
San Juan Pueblo, NM 87566-1155
Phone (505) 747-8711
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2005-0573 | NM | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248134400000",
"number": "1073743316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1155",
"city": "SAN JUAN PUEBLO",
"state": "NM",
"postal_code": "875661155",
"telephone_number": "505-747-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34020 US HIGHWAY 285",
"address_2": "C/O RANCHO DE SAN JUAN",
"city": "OJO CALINETE",
"state": "NM",
"postal_code": "87549",
"telephone_number": "505-747-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "DUDLEY",
"middle_name": "DEMAREE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-21",
"last_updated": "2009-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NM",
"license": "MD2005-0573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.