Wanda McDaniel, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN038289NP Issued in GA

Practice address

50 Kelly Rd
McDonough, GA 30253-6012

Phone

(770) 957-1887

Fax

(770) 957-6864

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1457460669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KELLY RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536012",
            "telephone_number": "770-957-1887",
            "fax_number": "770-957-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KELLY RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536012",
            "telephone_number": "770-957-1887",
            "fax_number": "770-957-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "WANDA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN038289NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "1153620002",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10033124",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "319962",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000821356A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kwasi Mbwana
• Angel Joy McCaskill
• Alex Chebron McCollum
• Erica Breann McCrae
• Xavier M McCullough, PTA
• Alvin O McDonald, NP-C
• Christen Peeper McDonald, PHD, LPC, ACS
• Donna Marie McDonald, NCC, LAPC
• Nicola McDonald
• McDonough Center for Family Dentistry, LLC

• Family Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.