Individual provider Active NPI

Matthew Allen Daniel, DO

  • Student in an Organized Health Care Education/Training Program
  • Myrtle Beach, SC
National Provider Identifier
1871236364
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 692-1595
NPI assigned
Apr 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

4330 Sabal Dr
Evans, GA 30809-7274
Phone (706) 825-8164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20230919000505 SC Order and Referring Only - General SurgeryPractitioner - General Surgery 6507220969

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: matthew.daniel@hca5.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1871236364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 SABAL DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097274",
            "telephone_number": "706-825-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "MATTHEW",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.