Individual provider Active NPI

Daniel Gunnar McDermott, RN, BSN

  • Registered Nurse
  • Dallas, TX
National Provider Identifier
1649753013
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2325702 Issued in MA
Practice address
604 Fort Worth Ave Apt 2139
Dallas, TX 75208-0259
Phone
(774) 571-7867
NPI assigned
Sep 12, 2018
Last updated
Sep 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2325702 MA Primary

Addresses

Primary practice location

604 Fort Worth Ave Apt 2139
Dallas, TX 75208-0259

Mailing address

604 Fort Worth Ave Apt 2139
Dallas, TX 75208-0259
Phone (774) 571-7867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2325702MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1649753013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 FORT WORTH AVE APT 2139",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752080259",
            "telephone_number": "774-571-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 FORT WORTH AVE APT 2139",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752080259",
            "telephone_number": "774-571-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "DANIEL",
        "middle_name": "GUNNAR",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2325702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.