Individual provider Active NPI

Madelynn Lovelady

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1780413880
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119733 Issued in FL
Practice address
1511 Surgeons Dr
Tallahassee, FL 32308-4680
Phone
(850) 701-0695
Fax
(850) 701-0696
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119733 FL Primary

Addresses

Primary practice location

1511 Surgeons Dr
Tallahassee, FL 32308-4680

Mailing address

1511 Surgeons Dr
Tallahassee, FL 32308-4680
Phone (850) 701-0695

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

State licenses

LicenseStateTypeSpecialty
PA9119733FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Medical Group, PLLC CurrentSince Feb 2, 2025 Accepting new patients
Tmgim PLLC PastSince Feb 2, 2025 Accepting new patients

Locations

1511 Surgeons Dr
Tallahassee, FL 32308
Phone (850) 701-0695

Organizations & group practices 2

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": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1780413880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 SURGEONS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084680",
            "telephone_number": "850-701-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 SURGEONS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084680",
            "telephone_number": "850-701-0695",
            "fax_number": "850-701-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELADY",
        "first_name": "MADELYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.