Individual provider Active NPI

Daniel P Golightly Jr., MD

  • Addiction Medicine (Family Medicine) Physician
  • Smyrna, GA
National Provider Identifier
1508955071
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
012470 Issued in GA
Practice address
3188 Atlanta Rd SE
Smyrna, GA 30080-8256
Phone
(770) 319-6000
Fax
(770) 319-6330
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 12470 GA
Addiction Medicine (Family Medicine) Physician 207QA0401X 012470 GA Primary

Addresses

Primary practice location

3188 Atlanta Rd SE
Smyrna, GA 30080-8256

Mailing address

3188 Atlanta Rd SE
Smyrna, GA 30080-8256
Phone (770) 319-6000

Other identifiers 1

IdentifierTypeStateIssuer
000017509KMedicaidGA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000814 GA Practitioner - Addiction MedicinePractitioner - Psychiatry 6103072129 Reassigns benefits to 1 organization
Practice locations: Smyrna, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012470GAMDAddiction Medicine (Family Medicine) Physician
12470GAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wholeness Within LLC Addiction Psychiatry CurrentSince Sep 21, 2023 Accepting new patients
Daniel Paul Golightly MD LLC PastSince Apr 1, 1994 Accepting new patients
Fulton County Mental Health Center Past Accepting new patients
Fulton County Mhddad Past Accepting new patients
Tangu, Inc PastSince Aug 6, 2019 Accepting new patients

Locations

4292 Memorial Dr
Ste C
Decatur, GA 30032
Phone (404) 597-3613

Organizations & group practices 5

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1508955071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3188 ATLANTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808256",
            "telephone_number": "770-319-6000",
            "fax_number": "770-319-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 ATLANTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808256",
            "telephone_number": "770-319-6000",
            "fax_number": "770-319-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLIGHTLY",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "GA",
            "license": "12470",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "012470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000017509K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.