Active NPI
Robert Keith Daniels Jr., M.D.
- Surgery Physician
- Columbus, GA
National Provider Identifier
1457333940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 00019461
- Practice address
- 920 18TH St
Columbus, GA 31901-1524 - Phone
- (706) 649-6600
- Fax
- (706) 649-6614
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 00019461 | GA | Primary |
| Surgery Physician | 208600000X | 00019461 | AL |
Addresses
Primary practice location
920 18TH St
Columbus, GA 31901-1524
Mailing address
PO Box 1038
Columbus, GA 31902-1038
Phone (706) 649-6600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009903545 | Medicaid | AL | |
| 000689939B | Medicaid | GA |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060404000666 | GA | Practitioner - General Surgery | 4183632086 | Practice locations: Columbus, GA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00019461 | AL | MD | Surgery Physician |
| 00019461 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1457333940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1038",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319021038",
"telephone_number": "706-649-6600",
"fax_number": "706-649-6614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 18TH ST",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319011524",
"telephone_number": "706-649-6600",
"fax_number": "706-649-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "ROBERT",
"middle_name": "KEITH",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "00019461",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "00019461",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009903545",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000689939B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.