Individual provider Active NPI

Destiny Danielle Nelson, NP

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1417816612
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP712281 Issued in GA
Practice address
345 Huntington Place CT
McDonough, GA 30253-8651
Phone
(678) 782-6920
NPI assigned
Jan 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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 APRN-NP712281 GA Primary

Addresses

Primary practice location

345 Huntington Place CT
McDonough, GA 30253-8651

Mailing address

675 Lafayette Ave Apt 5112
Fayetteville, GA 30214-8811
Phone (337) 335-7487

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
I20260323001909 GA Practitioner - Nurse Practitioner 3072097526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2129 Friendship Rd
Suite 100
Buford, GA 30519-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP712281GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medlife Healthcare LLC Family Medicine CurrentSince Feb 25, 2026 Accepting new patients
Medlife Urgent Care LLC CurrentSince Feb 25, 2026 Accepting new patients

Locations

2129 Friendship Rd
Ste 100
Buford, GA 30519
Phone (770) 209-2787

345 Huntington Place Ct
Ste 200B
McDonough, GA 30253
Phone (678) 993-0820

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1417816612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 LAFAYETTE AVE APT 5112",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302148811",
            "telephone_number": "337-335-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "678-782-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DESTINY",
        "middle_name": "DANIELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP712281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.