Active NPI
Lateef Daly, PA
- Physician Assistant
- Columbia, SC
National Provider Identifier
1780250779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4500 8TH Division Rd
Columbia, SC 29207-5700 - Phone
- (803) 751-2502
- NPI assigned
- Jun 1, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4500 8TH Division Rd
Columbia, SC 29207-5700
Mailing address
4500 8TH Division Rd
Columbia, SC 29207-5700
Phone (803) 751-2502
Other practice location 1
6600 Van Aalst Blvd Bldg 92501
Fort Benning, GA 31905-2102
Phone (888) 293-2273
Other practice location 2
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lateef.a.daly.mil@mail.mil |
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1780250779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 8TH DIVISION RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 8TH DIVISION RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-2502"
}
],
"practiceLocations": [
{
"address_1": "6600 Van Aalst Blvd Bldg 92501",
"address_purpose": "LOCATION",
"city": "Fort Benning",
"state": "GA",
"postal_code": "319052102",
"country_code": "US",
"telephone_number": "888-293-2273",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1061 Harmon Ave",
"address_purpose": "LOCATION",
"city": "Fort Stewart",
"state": "GA",
"postal_code": "313145641",
"country_code": "US",
"telephone_number": "912-435-6965",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALY",
"first_name": "LATEEF",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-01",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lateef.a.daly.mil@mail.mil",
"affiliation": "N",
"address_1": "6600 Van Aalst Blvd Bldg 92501",
"city": "Fort Benning",
"state": "GA",
"country_code": "US",
"postal_code": "319052102",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.