Individual provider Active NPI

William Daniel, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Fayetteville, TN
National Provider Identifier
1629450614
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN0000019978 Issued in TN
Practice address
106 Medical Center Blvd
Fayetteville, TN 37334
Phone
(931) 438-1100
NPI assigned
Jun 25, 2015
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN0000019978 TN Primary

Addresses

Primary practice location

106 Medical Center Blvd
Fayetteville, TN 37334

Mailing address

37 Day Road
Leoma, TN 38468
Phone (931) 279-1826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20151110002089 TN Practitioner - Nurse Practitioner 8628388261 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians
Apogee Medical Group Tennessee PCGroup PAC ID 4688721863, 24 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

1265 E College St
Pulaski, TN 38478-4541
Phone (931) 363-9374

129 N Locust Ave
Lawrenceburg, TN 38464-3757
Phone (931) 762-7232

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000019978TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Oct 1, 2015 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 17, 2019 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 17, 2019 Accepting new patients
App of Tennessee HM, PLLC CurrentSince Sep 30, 2018 Accepting new patients
Apogee Medical Group Tennessee PC CurrentSince Dec 18, 2019 Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

1265 E College St
Pulaski, TN 38478
Phone (931) 363-7531

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1629450614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 DAY ROAD",
            "city": "LEOMA",
            "state": "TN",
            "postal_code": "38468",
            "telephone_number": "931-279-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MEDICAL CENTER BLVD",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "37334",
            "telephone_number": "931-438-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000019978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, TN

Sources for this page

Verify at the official NPI Registry.