Active NPI
Delois Daniels, APRN
- Women's Health Nurse Practitioner
- Fairfax, SC
National Provider Identifier
1104979061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 830
- Practice address
- 333 Revolutionary TRL
Fairfax, SC 29827-7109 - Phone
- (803) 632-2533
- Fax
- (803) 632-3285
- NPI assigned
- Jan 22, 2007
- Last updated
- Feb 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 830 | SC | Primary |
Addresses
Primary practice location
333 Revolutionary TRL
Fairfax, SC 29827-7109
Mailing address
333 Revolutionary TRL
Fairfax, SC 29827-7109
Phone (803) 632-2533
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 |
|---|---|---|---|
| 830 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329177600000",
"number": "1104979061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 REVOLUTIONARY TRL",
"city": "FAIRFAX",
"state": "SC",
"postal_code": "298277109",
"telephone_number": "803-632-2533",
"fax_number": "803-632-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 REVOLUTIONARY TRL",
"city": "FAIRFAX",
"state": "SC",
"postal_code": "298277109",
"telephone_number": "803-632-2533",
"fax_number": "803-632-3285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "DELOIS",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2012-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "SC",
"license": "830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.