Individual provider Active NPI

Michael Nathan McDaniels, D.C.

  • Chiropractor
  • Orange Park, FL
National Provider Identifier
1790965580
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9367 Issued in FL
Practice address
2233 Park Ave
200-B
Orange Park, FL 32073-5570
Phone
(904) 375-2308
Fax
(904) 375-1954
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9367 FL Primary

Addresses

Primary practice location

2233 Park Ave
200-B
Orange Park, FL 32073-5570

Mailing address

2233 Park Ave
200-B
Orange Park, FL 32073-5570
Phone (904) 375-2308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110520000644 FL Practitioner - Chiropractic 7214113588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2233 Park Ave
200B
Orange Park, FL 32073-5567
Phone (904) 375-2308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9367FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Disc Center Chiropractor CurrentSince May 2, 2011 Accepting new patients

Locations

2233 Park Ave
Ste 200B
Orange Park, FL 32073
Phone (904) 375-2308

Organizations & group practices 1

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1790965580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 PARK AVE",
            "address_2": "200-B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735570",
            "telephone_number": "904-375-2308",
            "fax_number": "904-375-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 PARK AVE",
            "address_2": "200-B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735570",
            "telephone_number": "904-375-2308",
            "fax_number": "904-375-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIELS",
        "first_name": "MICHAEL",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.