DEDRICK MICHELLE DANIELS (NPI# 1730402975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730402975 |
| Entity Type | Individual |
| Full Name | DEDRICK MICHELLE DANIELS |
| Credential | DPM |
| Practice Address |
1760 Edgewood Ave W Jacksonville FL 32208-7209 |
| Practice Telephone | 9176861831 |
| Practice Fax Number | 2058798259 |
| Mailing Telephone | 9176861831 |
| Mailing Fax Number | 2058798259 |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2016-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001172 | GA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003112635A | 05 | |
| GA | RAILROAD MEDICARE | P01002642 | 01 |
| Street Address |
1760 EDGEWOOD AVE W |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-7209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568426302 | Willie A Pennick | Family Medicine | 1760 Edgewood Ave W, Suite B, Jacksonville, FL 32208-7209 | 2006-04-17 |
| 1720444557 | Elite Ankle and Foot LLC | Podiatrist | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2016-01-09 |
| 1699020446 | Fl Department of Health | Public Health or Welfare | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2012-07-18 |
| 1205109410 | Danna Charlene Morris | Nurse Practitioner | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2012-02-17 |
| 1861661506 | Doris Marie Chance | Physician Assistant | 1760 Edgewood Ave W, B, Jacksonville, FL 32208-7209 | 2008-02-27 |
| 1215059829 | Linda Lou Tisdale | Nurse Practitioner | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2007-04-04 |
| 1013006691 | Maria Susan Martinez | Social Worker | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-10-12 |
| 1851345714 | Kenneth E Nixon | Family Medicine | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-05-22 |
| 1811941677 | James L Gentry | Pediatrics | 1760 Edgewood Ave W, Jacksonville, FL 32208-7209 | 2006-05-19 |
| 1194789958 | Pennic, Wooten& Associates Family Medical Care Pa | Family Medicine | 1760 Edgewood Ave W, B, Jacksonville, FL 32208-7209 | 2006-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245751692 | Florida Foot and Ankle,inc | Podiatrist | 13241 Bartram Park Blvd Unit 1805, Jacksonville, FL 32258-5227 | 2017-07-06 |
| 1295264224 | Podiatrist On Call, LLC | Podiatrist | 2720 Park St Ste 210, Jacksonville, FL 32205-7645 | 2017-06-04 |
| 1992190524 | Richard C Harris IIi | Podiatrist | 655 W 8th St # C126, Jacksonville, FL 32209 | 2015-03-31 |
| 1497167779 | Jessica Isabel Popelka | Podiatrist | 13241 Bartram Park Blvd Unit 1809, Jacksonville, FL 32258-5227 | 2014-05-21 |
| 1417215609 | Samuel D Kulick Dpm | Podiatrist | 9397 San Jose Blvd Ste 1, Jacksonville, FL 32257-5587 | 2012-04-25 |
| 1699053819 | Troy A Harris | Podiatrist | 1560 Lancaster Ter Apt 206, Jacksonville, FL 32204-4116 | 2011-07-22 |
| 1679701429 | Lindsay Mae Chandler | Podiatrist | 655 W 8th St # C-126, Jacksonville, FL 32209-6511 | 2009-06-30 |
| 1659557239 | Foot Clinic-dr. S.f. Wernow | Podiatrist | 9397-1 San Jose Blvd, Jacksonville, FL 32257-5587 | 2008-01-14 |
| 1669692844 | Sheldon F Wernow | Podiatrist | 9397 San Jose Boulevard, Suite 1, Jacksonville, FL 32257-5587 | 2007-04-27 |
| 1144352386 | Richard I Polisner | Podiatrist | 4621 Emerson St, Jacksonville, FL 32207-4920 | 2007-03-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
Please comment or provide details below to improve the information on DEDRICK MICHELLE DANIELS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.