Individual provider Active NPI

Jamison William Daniels, P.A.

  • Physician Assistant
  • Gainesville, GA
National Provider Identifier
1467832923
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Wisteria Dr
Gainesville, GA 30501-3827
Phone
(770) 219-5407
NPI assigned
May 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

200 Wisteria Dr
Gainesville, GA 30501-3827

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

2160 Fountain Dr Suite 100
Eastside Behavioral Health Associates
Snellville, GA 30078-7022
Phone (770) 985-6460

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdaniels105867@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jamison.daniels@hca1.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1467832923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WISTERIA DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013827",
            "telephone_number": "770-219-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 Fountain Dr Suite 100",
            "address_2": "Eastside Behavioral Health Associates",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300787022",
            "country_code": "US",
            "telephone_number": "770-985-6460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JAMISON",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-31",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdaniels105867@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Wisteria Dr",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.