Individual provider Active NPI

Kaitlin Neese McDaniel, PA-C

  • Rheumatology Physician
  • Cumming, GA
National Provider Identifier
1124604889
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
PENDING Issued in GA
Practice address
102 Mary Alice Park Rd Ste 805
Cumming, GA 30040-4702
Phone
(678) 438-5921
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X PENDING GA Primary

Addresses

Primary practice location

102 Mary Alice Park Rd Ste 805
Cumming, GA 30040-4702

Mailing address

102 Mary Alice Park Rd Ste 805
Cumming, GA 30040-4702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251210003954 GA Practitioner - Physician Assistant 1951895515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

100 Mountain View Dr
Suite 100
Cumming, GA 30040-2434
Phone (770) 889-2163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGGAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis & Rheumatology Center PC Single Specialty CurrentSince Nov 26, 2025 Accepting new patients

Locations

102 Mary Alice Park Rd
Ste 805
Cumming, GA 30040
Phone (678) 438-5921

11685 Alpharetta Hwy
Ste 120
Roswell, GA 30076
Phone 7702843150407

3921 Johns Creek Ct
Ste C
Suwanee, GA 30024
Phone 7702843150458

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAADCA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1124604889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MARY ALICE PARK RD STE 805",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300404702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MARY ALICE PARK RD STE 805",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300404702",
            "telephone_number": "678-438-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "KAITLIN",
        "middle_name": "NEESE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.