Tara Brinson McDaniel, CCMA

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

236472 Issued in FL

Practice address

5791 University Club Blvd N Unit 208
Jacksonville, FL 32277-9406

Phone

(904) 405-5181

NPI assigned

Feb 12, 2021

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 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.

• Sisters With Love Home Health LLC

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1922686195
  NPD Authorized official

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1215520929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5791 UNIVERSITY CLUB BLVD N UNIT 208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322779406",
            "telephone_number": "904-405-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5791 UNIVERSITY CLUB BLVD N UNIT 208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322779406",
            "telephone_number": "904-405-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "TARA",
        "middle_name": "BRINSON",
        "name_prefix": "Ms.",
        "credential": "CCMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "236472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769789",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin McDaniel, MSD, DMD, MS
• Layla Brock McDaniel, PA-C
• Loviya McDaniel
• Sean Michael McDaniel, PSYD
• Tana McDaniel, NP
• Victoria Felice McDavid, APRN11041611
• Alicia McDermott
• Logan Budd McDermott, MD
• Madison Carter McDermott
• Peter Christopher McDermott, ARNP

• Home Health Aide in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Home Health Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.