Individual provider Active NPI

Tana McDaniel, NP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1679465645
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11040973 Issued in FL
Practice address
1827 Mount Vernon Dr
Jacksonville, FL 32210-1253
Phone
(352) 263-7474
NPI assigned
Jul 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 11040973 FL Primary

Addresses

Primary practice location

1827 Mount Vernon Dr
Jacksonville, FL 32210-1253

Mailing address

1827 Mount Vernon Dr
Jacksonville, FL 32210-1253
Phone (352) 263-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250825004278 FL Practitioner - Nurse Practitioner 2466952205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dover Shores Family PracticeGroup PAC ID 7517336431, 14 clinicians

Practice addresses (Care Compare)

4540 Southside Blvd
Suite 401
Jacksonville, FL 32216-5488
Phone (904) 567-5338

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11040973FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Specialists of Orlando LLC Current Accepting new patients
Dover Shores Family Practice CurrentSince Aug 12, 2025 Accepting new patients
Traditions Family Medicine, LLC PastSince Oct 31, 2021 Accepting new patients

Locations

4540 Southside Blvd
Ste 401
Jacksonville, FL 32216
Phone (904) 566-9256

4711 Curry Ford Rd
Ste B
Orlando, FL 32812
Phone (407) 275-6810

Interoperability endpoints

  • Direct secure messaging: tana.mcdaniel.1@31553.direct.athenahealth.com

Organizations & group practices 3

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": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1679465645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 MOUNT VERNON DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101253",
            "telephone_number": "352-263-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 MOUNT VERNON DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101253",
            "telephone_number": "352-263-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "TANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.