Individual provider Active NPI

Virginia McDaniel, CRNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1609435155
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-150182 Issued in AL
Practice address
1722 Pine St
Montgomery, AL 36106-1103
Phone
(334) 293-8588
NPI assigned
Jun 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-150182 AL Primary

Addresses

Primary practice location

1722 Pine St
Montgomery, AL 36106-1103

Mailing address

912 Will Logan Rd
Ozark, AL 36360-5188
Phone (850) 209-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20191024002765 AL Practitioner - Nurse Practitioner 3779815733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

1812 E Main St
Dothan, AL 36301-3000
Phone (334) 793-6573

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Dothan, AL, CCN 017159
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Laboratory Associates Current Accepting new patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority CurrentSince Sep 1, 2020 Accepting new patients
Jackson Hospital and Clinic, Inc. CurrentSince Aug 4, 2019 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Aug 4, 2019 Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1812 E Main St
Dothan, AL 36301
Phone (334) 793-6573

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1722 Pine St
Montgomery, AL 36106
Phone (334) 288-1916

1722 Pine St
Ste 502
Montgomery, AL 36106
Phone (334) 293-8123

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1609435155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WILL LOGAN RD",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363605188",
            "telephone_number": "850-209-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-293-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "VIRGINIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-150182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.