Individual provider Active NPI

Dan McDaniel, MD

  • Family Medicine Physician
  • Red Bluff, CA
National Provider Identifier
1861527459
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A22149 Issued in CA
Practice address
2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone
(530) 527-0414
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A22149 CA Primary

Addresses

Primary practice location

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356

Mailing address

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356

Other identifiers 2

IdentifierTypeStateIssuer
GR0089250MedicaidCA
RHM53955FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827001172 CA Order and Referring Only - Family PracticePractitioner - Family Practice 9638161326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A22149CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Healthcare West Past Accepting new patients
Dignity Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dan.mcdaniel.2@10692.direct.athenahealth.com

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1861527459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356",
            "telephone_number": "530-527-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "DAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A22149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089250",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53955F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

Verify at the official NPI Registry.