Diedre Daniels, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

102615 Issued in TX

Practice address

7330 Fern Ave Ste 503
Shreveport, LA 71105-4983

Phone

(866) 730-0707

NPI assigned

Apr 25, 2007

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 names 1

• Dee Daniels Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wowyfitness, LLCGroup PAC ID 8224440003, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wowyfitness, LLC

  • Rehabilitation Clinic/Center
  • Richardson, TX
  • NPI 1437761178
  Medicare reassignment Care Compare group
• On Point MVP LLC

  • Rehabilitation Clinic/Center
  • Richardson, TX
  • NPI 1811604242
  NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1134349079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 ZODIAC DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750446646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 503",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054983",
            "telephone_number": "866-730-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "DIEDRE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE",
            "last_name": "DANIELS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• April Lynne Daniel, M.A.
• Trina Lashay Daniel
• Daniels Family Medical Center LLC
• Akane Daniels, P.A.
• Byron Daniels, BA
• Julie Daniels, COTA/L
• Kelly Daniels, PT, DPT
• Larry Clyde Daniels, MD
• Margaret Eva Daniels, LPC
• Timothy Francis Danish, MD

• Speech-Language Pathologist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.