Taidesha Chanel Myrick, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN298582 Issued in GA

Practice address

2035 Flat Shoals Rd SE
Conyers, GA 30013-1809

Phone

(770) 922-1778

NPI assigned

Aug 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Emory University School of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIHDBA

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.

• Caedel Medical Group

  • Internal Medicine Physician
  • Riverdale, GA
  • NPI 1710922075
  Medicare reassignment NPD

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

{
    "created_epoch": "1725062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725062400000",
    "number": "1710711684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3413",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300313413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 FLAT SHOALS RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131809",
            "telephone_number": "770-922-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "TAIDESHA",
        "middle_name": "CHANEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-31",
        "last_updated": "2024-08-31",
        "certification_date": "2024-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN298582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanja E Mwangi, MD, MPH
• My Froggy Stuff Home Care
• My Healing Angels LLC
• Ludeni Nadeen Myers
• Calvin Wint Maung Myint, M.D
• Shenell Myrie, PSY.D.
• Rajeev Nagaraj Mysorekar, M.D.
• Sepedeh Nabavi, M.D.
• Sarveswar I Naidu, MD
• Kelsey Ann Nance-Judge, PTA

• Adult Health Nurse Practitioner in Conyers, GA
• Providers in Conyers, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.