TAIDESHA CHANEL MYRICK NP
NPI 1710711684
Nurse Practitioner - Adult Health in Conyers, GA

Q: What is Taidesha Myrick's NPI number?

The NPI number for Taidesha Myrick is 1710711684. It was assigned to this individual provider in the NPPES registry on August 31, 2024.

Q: What is Taidesha Myrick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Taidesha Myrick was last updated on August 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 31, 2024PECOS Enrolled

2035 FLAT SHOALS RD SE, CONYERS, GA 30013(770) 922-1778 Get Directions Write a Review

NPPES record last updated: August 31, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Taidesha Chanel Myrick Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAIDESHA CHANEL MYRICK NP (NPI 1710711684) is an individual adult health provider in Conyers, Georgia, licensed in Georgia (RN298582) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Emory University School Of Medicine (2021).

NPPES Registry Identity

NPI1710711684

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameTAIDESHA CHANEL MYRICKCredential: NP

Location Address2035 FLAT SHOALS RD SEConyers, GA 30013-1809

Mailing AddressPo Box 3413Decatur, GA 30031-3413

Phone(770) 922-1778

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2021

Enumeration DateAugust 31, 2024

NPPES CertifiedAugust 31, 2024

✔ NPI 1710711684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in GA · RN298582

2035 FLAT SHOALS RD SE, Conyers, GA 30013

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Taidesha Chanel Myrick Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476058918

PECOS Enrollment IDI20250925000650

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KIREN TUSHAR NP

Nurse Practitioner (Family)