Mary E Dannelly, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN 380 Issued in SC

Practice address

1316 N Lake Dr
Lexington, SC 29072-7653

Phone

(803) 358-1191

Fax

(803) 358-1180

NPI assigned

Apr 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Riley Family Practice Associates PA

  • Family Medicine Physician
  • Saluda, SC
  • NPI 1992769665
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1124082805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727653",
            "telephone_number": "803-358-1191",
            "fax_number": "803-358-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNELLY",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN 380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1849",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Charles Dalzell, BA
• Sara D. Damewood, MSW, LISW-CP
• Daniel & Max, LLC
• Charlotte Daniels
• Wesley Holland Daniels, PHARMD
• Laura Banner Dantzler, RDH
• Madisson Darms, PT
• Himadri Dasgupta, MD
• Rachel Datz, PHARMD
• Kyle Richard Daugherty, DPT

• All providers in Lexington, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.