Individual provider Active NPI

Weaton M McDaniel, MP-C

  • Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1467022939
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904710 Issued in MS
Practice address
1430 Jefferson St
Laurel, MS 39440-4243
Phone
(601) 425-2273
Fax
(601) 426-9637
NPI assigned
Jun 28, 2021
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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 904710 MS Primary
Family Nurse Practitioner 363LF0000X 904710 MS

Addresses

Primary practice location

1430 Jefferson St
Laurel, MS 39440-4243

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Other practice location 1

704 S 5th St
Collins, MS 39428-4147
Phone (601) 765-4414

Other practice location 2

1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 426-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210920002548 MS Practitioner - Nurse Practitioner 3678970571 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
Telehealth
Offers telehealth services
Group practices
South Central Clinics, IncGroup PAC ID 4385876655, 117 clinicians
Covington County HospitalGroup PAC ID 4183517253, shared by 16 NPIs, 44 clinicians

Practice addresses (Care Compare)

1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226

1203 Jefferson St
Laurel, MS 39440-4354
Phone (601) 649-2863

PO Box
Suite 2499
Collins, MS 39428

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital CurrentSince Aug 1, 2021 Accepting new patients
South Central Clinics, Inc CurrentSince Jul 1, 2025 Accepting new patients
Covington County Hospital CurrentSince Feb 5, 2024 Accepting new patients
Covington County Hospital Current Accepting new patients
South Central Cinics, Inc CurrentSince Jul 1, 2025 Accepting new patients
Covington County Hospital CurrentSince Oct 29, 2024 Accepting new patients
Green Tree Family Medical Clinic Current Accepting new patients
South Central Clinics, Inc Current Accepting new patients

Locations

3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

1430 Jefferson St
Laurel, MS 39440
Phone (601) 425-2273

Organizations & group practices 8

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1467022939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404243",
            "telephone_number": "601-425-2273",
            "fax_number": "601-426-9637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Collins",
            "state": "MS",
            "postal_code": "394284147",
            "country_code": "US",
            "telephone_number": "601-765-4414",
            "fax_number": "601-765-9141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394404355",
            "country_code": "US",
            "telephone_number": "601-426-4000",
            "fax_number": "601-399-6184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "WEATON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904710",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.