Individual provider Active NPI

Linda R McDaniel, CNM

  • Advanced Practice Midwife
  • Villa Rica, GA
National Provider Identifier
1497982656
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN191724 Issued in GA
Practice address
690 Dallas Hwy
Suite 301
Villa Rica, GA 30180-1264
Phone
(770) 456-3850
Fax
(770) 456-3826
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN191724 GA Primary
Registered Nurse First Assistant 163WR0006X RN191724 GA

Addresses

Primary practice location

690 Dallas Hwy
Suite 301
Villa Rica, GA 30180-1264

Mailing address

690 Dallas Hwy
Suite 301
Villa Rica, GA 30180-1264
Phone (770) 456-3850

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206000758 GA Practitioner - Certified Nurse Midwife (CNM) 9537356324 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN191724GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 8, 2016 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 8, 2016 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Tanner Medical Group Inc CurrentSince Nov 8, 2010 Accepting new patients

Locations

1791 Mulkey Rd
Ste 200
Austell, GA 30106
Phone (770) 732-5400

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

120 Greystone Power Blvd
Ste 100
Dallas, GA 30157
Phone (678) 945-8345

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

690 Dallas Hwy
Ste 301
Villa Rica, GA 30180
Phone (770) 456-3850

Interoperability endpoints

  • Direct secure messaging: lmcdaniel127973@directwellstar.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1497982656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY",
            "address_2": "SUITE 301",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801264",
            "telephone_number": "770-456-3850",
            "fax_number": "770-456-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY",
            "address_2": "SUITE 301",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801264",
            "telephone_number": "770-456-3850",
            "fax_number": "770-456-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "LINDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN191724",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN191724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.