Daliannys Morales Mendez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

074218 Issued in GA

Practice address

4905 Courtney Dr
Forest Park, GA 30297-1427

Phone

(404) 366-3636

Fax

(404) 362-0808

NPI assigned

Apr 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmoralesmendez400968@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1437449964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971427",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971427",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4441 Atlanta Rd SE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806442",
            "country_code": "US",
            "telephone_number": "470-956-4180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORALES MENDEZ",
        "first_name": "DALIANNYS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME119519",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "074218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010967700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoralesmendez400968@directwellstar.org",
            "affiliation": "N",
            "address_1": "4441 Atlanta Rd SE Ste 201",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300806442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bernadette Merricks, D.C.
• Jair Emilio Millan
• Wanda Miller
• Minwil
• Aliyah Montgomery-Hawthorne, LPC
• Clarence E Morgan Jr., M.D.
• Natascha Mosley
• Denise Moten, DPT
• Motion PT Group Georgia LLC
• Mouthpeace Dental 4, LLC

• Pediatrics Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.