DEDRICK MICHELLE DANIELS (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1730402975
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DEDRICK MICHELLE DANIELS (DPM)
120 KING ST
JACKSONVILLE, FL 322042410
Phone: (904) 760-4904
Type: Mailing
2251 W Elm St
Wrightsville, GA 310962017
Phone: (478) 864-2600
Fax: (478) 864-1288
Type: Location
5460 Blanding Blvd
Jacksonville, FL 322441957
Phone: (904) 760-4904
Fax: (904) 779-5263
Type: Location
PO BOX 3035
THOMASVILLE, GA 317993035
Phone: (202) 276-9478
Type: Mailing
2251 W ELM ST
WRIGHTSVILLE, GA 310962017
Phone: (478) 864-2600
Fax: (478) 864-1288
Type: Location
Edgewood Avenue West, Lake Forest Manor, Jacksonville, Duval County, Florida, 32209, United States
JACKSONVILLE, FL 322087209
Phone: (917) 686-1831
Fax: (205) 879-8259
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-12-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110830000616 | I | Podiatry | GA | TBD |
| I20141209000024 | I | Podiatry | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32204)
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