Mary Phylinda Redeker McDaniel, PNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

699906 Issued in TX

Practice address

333 N Santa Rosa St
San Antonio, TX 78207-3108

Phone

(210) 704-2190

NPI assigned

Sep 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Phylinda Redeker Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Baylor College of Medicine

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764
  Medicare reassignment NPD
• Victoria Emergency Partners LLC

  • Emergency Medicine Physician
  • Gonzales, TX
  • NPI 1164770996
  Medicare reassignment NPD

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558137600000",
    "number": "1194075705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5738 THUNDER OAKS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78261",
            "telephone_number": "210-737-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 N San Saba Ste 1135",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073255",
            "country_code": "US",
            "telephone_number": "210-704-3030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7700 Floyd Curl Drive",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78229",
            "country_code": "US",
            "telephone_number": "210-575-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "MARY PHYLINDA",
        "middle_name": "REDEKER",
        "credential": "PNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2019-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "699906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY PHYLINDA",
            "last_name": "REDEKER",
            "credential": "PNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph L McDaniel, MD
• Joy Natasha McDaniel, DMD
• Kelly McDaniel, LPC
• Kristi McDaniel
• Leilani Choe McDaniel, DDS
• Nichole Jean McDaniel
• Robin McDaniel
• Winfield Scott McDaniel, MD
• Ku'Uhiaonani McDaniels, BCBA, LBA
• Kelly Jean McDaris, LVN

• Pediatric Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.