Individual provider Active NPI

Danielle Leigh Elam, NP

  • Nurse Practitioner
  • Hinesville, GA
National Provider Identifier
1962001255
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F10200818 Issued in GA
Practice address
455 S Main St Ste 104
Hinesville, GA 31313-4354
Phone
(912) 369-9400
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F10200818 GA Primary

Addresses

Primary practice location

455 S Main St Ste 104
Hinesville, GA 31313-4354

Mailing address

462 Elma G Miles Pkwy
Hinesville, GA 31313-4000

Other practice location 1

586 Islands Hwy
Midway, GA 31320-5962
Phone (912) 369-9400

Other practice location 2

73 Coastal Manor Dr SE
Ludowici, GA 31316-2949
Phone (912) 369-9400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210212000070 GA Practitioner - Nurse Practitioner 5991110504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

455 S Main St
Suite 104
Hinesville, GA 31313-4354
Phone (912) 876-5644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10200818GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Liberty County CurrentSince Nov 11, 2020 Accepting new patients
Hospital Authority of Liberty County Current Accepting new patients
Hospital Authority of Liberty County CurrentSince Nov 11, 2020 Accepting new patients

Locations

455 S Main St
Ste 104
Hinesville, GA 31313
Phone (912) 368-6226

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

128 Coastal Manor Dr SE
Ludowici, GA 31316
Phone (912) 545-3392

73 Coastal Manor Dr SE
Ludowici, GA 31316
Phone (912) 369-9313

586 Islands Hwy
Midway, GA 31320
Phone (912) 396-7050

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1962001255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 ELMA G MILES PKWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 104",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-369-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "586 Islands Hwy",
            "address_purpose": "LOCATION",
            "city": "Midway",
            "state": "GA",
            "postal_code": "313205962",
            "country_code": "US",
            "telephone_number": "912-369-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Coastal Manor Dr SE",
            "address_purpose": "LOCATION",
            "city": "Ludowici",
            "state": "GA",
            "postal_code": "313162949",
            "country_code": "US",
            "telephone_number": "912-369-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELAM",
        "first_name": "DANIELLE",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "F10200818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

Verify at the official NPI Registry.