MEDICARE: YOUR WAY MEDICAL HEALTH CARE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1427911924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR WAY MEDICAL HEALTH CARE CLINIC

Provider Business Mailing Address
First Line	:	653 ROBERTS DR STE A-4
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2959
Country	:	US
Telephone Number	:	678-361-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	653 ROBERTS DR STE A-4
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2959
Country	:	US
Telephone Number	:	678-361-2100
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAISY MELINDA KING-GODINEAUX
Credential	:	FNP
Telephone Number	:	678-361-2100

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	02/07/2026

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