Active NPI
Myra S Daniel, MD
- Family Medicine Physician
- Bettendorf, IA
National Provider Identifier
1891783569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28287
- Practice address
- 2140 53Rd Ave
Bettendorf, IA 52722-6279 - Phone
- (563) 421-5700
- Fax
- (563) 421-5749
- NPI assigned
- Oct 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28287 | IA | Primary |
Addresses
Primary practice location
2140 53Rd Ave
Bettendorf, IA 52722-6279
Mailing address
2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone (563) 421-5700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12352 | Other | IA | WELLMARK HEALTH PLAN |
| IA01N2 | Other | JOHN DEERE HEALTH PLAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | myra.daniel@direct.genesishealth.com | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26139 | IA | MD | Family Medicine Physician |
| 28287 | IA | MD | Family Medicine Physician |
Interoperability endpoints
- myra.daniel@direct.genesishealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619740800000",
"number": "1891783569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2140 53RD AVE",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527226279",
"telephone_number": "563-421-5700",
"fax_number": "563-421-5749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 53RD AVE",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527226279",
"telephone_number": "563-421-5700",
"fax_number": "563-421-5749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "MYRA",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-07",
"last_updated": "2021-04-30",
"certification_date": "2021-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "28287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK HEALTH PLAN",
"identifier": "12352",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH PLAN",
"identifier": "IA01N2",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "myra.daniel@direct.genesishealth.com",
"affiliation": "N",
"endpointDescription": "genesis health system direct email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "2140 53rd Ave",
"city": "Bettendorf",
"state": "IA",
"country_code": "US",
"postal_code": "527226279",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.