Karen Renee Daniel, NP
Individual provider Active NPI Family Nurse Practitioner · Warthen, GA
NPI 1104131671 · NPPES record last updated Jul 28, 2015
Key facts
- NPI
- 1104131671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F0610250 (GA)
- Practice address
- 4530 Bay Springs Rd
Warthen, GA 31094-4122 - Phone
- (678) 371-4655
- Fax
- (770) 582-4189
- NPI assigned
- Aug 9, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111214000425 | GA | Practitioner - Family Practice | 7315943305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0610250 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Care Systems, Inc | Current |
Accepting new patients | |
| Community Health Care Systems, Inc. | Current | Accepting new patients | |
| Community Health Care Systems, Inc | Current |
Accepting new patients |
Locations
2251 W Elm St
Wrightsville, GA 31096
Phone (478) 864-2600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0610250 | GA | Yes |
Addresses
Primary practice location
4530 Bay Springs Rd
Warthen, GA 31094-4122
Mailing address
4530 Bay Springs Rd
Warthen, GA 31094-4122
Phone (678) 371-4655
Other names
- Karen Renee Goldman
Other providers in Warthen, GA
All providers in Warthen, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.