Amanda Daugherty

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN283355 Issued in GA

Practice address

1550 Kennesaw Due West Rd NW
Kennesaw, GA 30152-4338

Phone

(470) 956-7716

NPI assigned

Jul 11, 2025

Sex

Unspecified or another gender identity

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1780575407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 KENNESAW DUE WEST RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 KENNESAW DUE WEST RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524338",
            "telephone_number": "470-956-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN283355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Dao-King, M.D.
• Rachel Darch
• Katherine Dart, RD, LD
• Candice Cheryl Darville, MD
• Adriana Kathryn Dason
• John Davanzo, RN
• David Fierce OD LLC
• David L Goettee D.D.S., P.C.
• Harley Alexander Davidson, D.C.
• Nicole Adriana Davidson, MD

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2025; 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.