Individual provider Active NPI

Maylissa Lydia Daniels, NP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1306578711
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
GAA-NP000646 Issued in GA
Practice address
2275 Marietta Blvd NW Ste 450
Atlanta, GA 30318-2004
Phone
(404) 367-4400
NPI assigned
Jun 27, 2022
Last updated
Nov 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X GAA-NP000646 GA Primary
Family Medicine Physician 207Q00000X GAA-NP000646 GA

Addresses

Primary practice location

2275 Marietta Blvd NW Ste 450
Atlanta, GA 30318-2004

Mailing address

2275 Marietta Blvd NW Ste 450
Atlanta, GA 30318-2004

Other practice location 1

564 Crosstown Dr
Peachtree City, GA 30269-2916
Phone (770) 282-2944

Other practice location 2

3240 S Cobb Dr SE
Smyrna, GA 30080
Phone (770) 433-3447

Other names 1

  • Maylissa Charmant Former name

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
I20220708002751 GA Practitioner - Nurse Practitioner 5597145441 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

2275 Marietta Blvd NW
Suite 450
Atlanta, GA 30318-2004
Phone (404) 367-4400

3800 Princeton Lakes Pkwy SW
Atlanta, GA 30331-5580
Phone (678) 732-1524

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GAA-NP000646GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC Family Medicine CurrentSince Dec 8, 2025 Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Vpa PC Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
TLC of Georgia LLC Family CurrentSince Jul 13, 2022 Accepting new patients
Capital Healthcare PC CurrentSince Sep 27, 2023 Accepting new patients
Alex E. Rikhter, MD P.C. Current Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Allcare Ga PC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1372 Peachtree St NE
Ste 100
Atlanta, GA 30309
Phone (470) 964-1700

2275 Marietta Blvd NW
Ste 450
Atlanta, GA 30318
Phone (404) 367-4400

3800 Princeton Lakes Pkwy SW
Atlanta, GA 30331
Phone (404) 344-5158

3867 Roswell Rd NE
Ste 100
Atlanta, GA 30342
Phone (678) 904-5611

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

100 S Peachtree Pkwy
Peachtree City, GA 30269
Phone (678) 732-1522

564 Crosstown Dr
Peachtree Cty, GA 30269
Phone (770) 282-2944

3240 S Cobb Dr SE
Smyrna, GA 30080
Phone (770) 433-3420

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: maylissa.charmant@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 9

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1306578711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 MARIETTA BLVD NW STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 MARIETTA BLVD NW STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182004",
            "telephone_number": "404-367-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "564 Crosstown Dr",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302692916",
            "country_code": "US",
            "telephone_number": "770-282-2944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3240 S Cobb Dr SE",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "30080",
            "country_code": "US",
            "telephone_number": "770-433-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MAYLISSA",
        "middle_name": "LYDIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP000646",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "GAA-NP000646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYLISSA",
            "last_name": "CHARMANT",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.