Active NPI
Ebonie McDaniel, NP
- Family Nurse Practitioner
- Columbia, SC
National Provider Identifier
1629635529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 22811
- Practice address
- 6439 Garners Ferry Rd
Columbia, SC 29209-1638 - Phone
- (803) 776-4000
- NPI assigned
- May 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 22811 | SC | Primary |
Addresses
Primary practice location
6439 Garners Ferry Rd
Columbia, SC 29209-1638
Mailing address
332 Meadow Saffron Dr
Lexington, SC 29073-9774
Phone (803) 238-2414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201217000636 | SC | Order and Referring Only - Nurse Practitioner | 0547672404 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1629635529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 MEADOW SAFFRON DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290739774",
"telephone_number": "803-238-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6439 GARNERS FERRY RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292091638",
"telephone_number": "803-776-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "EBONIE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-26",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "22811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.