Individual provider Active NPI

Lynnell Marie Daniel, M.D.

  • Anesthesiology Physician
  • Lackland a F B, TX
National Provider Identifier
1083688006
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01056042A Issued in IN
Practice address
2200 Bergquist Dr
Lackland Air Force Base
Lackland a F B, TX 78236-9907
Phone
(210) 292-7956
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01056042A IN Primary

Addresses

Primary practice location

2200 Bergquist Dr
Lackland Air Force Base
Lackland a F B, TX 78236-9907

Mailing address

3519 Blackstone Run
San Antonio, TX 78259-2619
Phone (210) 481-9120

Other names 1

  • Dr. Lynnell Marie Sorrells Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091016000489 LA Practitioner - Anesthesiology 0143377523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone (318) 212-4000

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01056042AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jul 8, 2017 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Anesthesiology CurrentSince Mar 10, 2014 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 8, 2017 Accepting new patients
Med-Trans Corporation Past Accepting new patients

Locations

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1083688006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 BLACKSTONE RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592619",
            "telephone_number": "210-481-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "LACKLAND AIR FORCE BASE",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "LYNNELL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01056042A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNELL",
            "last_name": "SORRELLS",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lackland a F B, TX

Sources for this page

Verify at the official NPI Registry.