Daniel John Cadwallader, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8793 Issued in GA

Practice address

803 S Main St
Greensboro, GA 30642-1211

Phone

(706) 453-1201

NPI assigned

Sep 6, 2005

Last updated

Jul 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oconee Valley Healthcare IncGroup PAC ID 0446232268, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniel.cadwallader.1@15507.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/15507/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Greensboro, GA
  • NPI 1255433736
  Medicare reassignment Care Compare group NPD
• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Greensboro, GA
  • NPI 1144771106
  NPD
• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Greensboro, GA
  • NPI 1215235320
  NPD
• Oconee Valley Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Milledgeville, GA
  • NPI 1790106623
  NPD
• Al Shaafi Medical PC

  dba Children's Medical Center of Tucson

  • Pediatrics Physician
  • Tucson, AZ
  • NPI 1316946445
  NPD (past)
• Pediatrics GPS, Inc

  • Pediatrics Physician
  • Tucson, AZ
  • NPI 1336758861
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1265426340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306421211",
            "telephone_number": "706-453-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306421211",
            "telephone_number": "706-453-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1041 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "GA",
            "postal_code": "306423465",
            "country_code": "US",
            "telephone_number": "706-453-4945",
            "fax_number": "706-453-2954",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Ga Highway 22 W",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "310616606",
            "country_code": "US",
            "telephone_number": "478-414-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 N Cobb St",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "310612635",
            "country_code": "US",
            "telephone_number": "478-414-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1040 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "GA",
            "postal_code": "306423466",
            "country_code": "US",
            "telephone_number": "706-534-6640",
            "fax_number": "706-400-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CADWALLADER",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charis Burhenn, FNP-BC
• Brenton Burrell
• Ronald Wayne Burris Jr., D.C.
• Suzanne Butler, D.C.
• Ricky Ray Byrd, MD
• Wendy E Cardenas, DMD
• Jensine Tomi Chemmalakuzhy, NP
• Harry Cheves III, M.D.
• Christopher J Bassett MD PC (Lake Oconee Pediatrics)
• Tawny Cobb

• Medical Physician Assistant in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.
• 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.