Individual provider Active NPI

Megan Elizabeth Wallace McDaniel, FNP

  • Family Nurse Practitioner
  • Roanoke, AL
National Provider Identifier
1295503175
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
GAA-NP001928 Issued in GA
Practice address
172 County Road 63
Roanoke, AL 36274-6106
Phone
(706) 957-7154
NPI assigned
Dec 19, 2023
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X GAA-NP001928 GA Primary

Addresses

Primary practice location

172 County Road 63
Roanoke, AL 36274-6106

Mailing address

172 County Road 63
Roanoke, AL 36274-6106
Phone (706) 957-7154

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
I20240214002664 GA Practitioner - Nurse Practitioner 7012351307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone (706) 530-2151

1825 Hwy 34 E
Suite 1200
Newnan, GA 30265-6416
Phone (770) 502-2121

1825 Hwy 34 E 1200
Newnan, GA 30265-6416

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

35 Arbor Springs Ter
Newnan, GA 30265-4214
Phone (470) 323-5200

706 Dixie St
Suite 320
Carrollton, GA 30117-3819
Phone (770) 836-9326

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP001928GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Feb 2, 2024 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1295503175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 COUNTY ROAD 63",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362746106",
            "telephone_number": "706-957-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 COUNTY ROAD 63",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362746106",
            "telephone_number": "706-957-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH WALLACE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, AL

Sources for this page

Verify at the official NPI Registry.