Individual provider Active NPI

Danielle Madlock, APRN

  • Family Nurse Practitioner
  • Mableton, GA
National Provider Identifier
1710331152
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN208494 Issued in GA
Practice address
5701 Mableton Pkwy SW Ste 348
Mableton, GA 30126-3395
Phone
(470) 454-3653
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN208494 GA Primary
Registered Nurse 163W00000X RN208494 GA

Addresses

Primary practice location

5701 Mableton Pkwy SW Ste 348
Mableton, GA 30126-3395

Mailing address

4696 Balley Shannon Dr SE
Mableton, GA 30126-1763
Phone (678) 360-2368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20181022003317 GA Practitioner - Nurse Practitioner 1456604420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4696 Balley Shannon Dr SE
Mableton, GA 30126-1763
Phone (470) 454-3653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN208494GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New Orleans Caring Hands LLC CurrentSince Jul 13, 2020 Accepting new patients
Clark Robinson, M.D.,P.C. PastSince Sep 11, 2018 Accepting new patients
Dekalb Community Service Board Past Accepting new patients
One Stop Medical Clinic Past Accepting new patients
Dekalb Community Service Board PastSince Sep 24, 2011 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1710331152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 BALLEY SHANNON DR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261763",
            "telephone_number": "678-360-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MABLETON PKWY SW STE 348",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263395",
            "telephone_number": "470-454-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADLOCK",
        "first_name": "DANIELLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN208494",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN208494",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

Verify at the official NPI Registry.