Paul McDonald, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

30017 Issued in TN

Practice address

104 W Main St
Henderson, TN 38340-2212

Phone

(731) 616-5175

NPI assigned

May 28, 2014

Last updated

May 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vascular Associates LLC

  • Specialist
  • Panama City, FL
  • NPI 1821129313
  NPD (past)

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1023420809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BRAY LN",
            "city": "BEECH BLUFF",
            "state": "TN",
            "postal_code": "383131822",
            "telephone_number": "731-616-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W MAIN ST",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402212",
            "telephone_number": "731-616-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9296521",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-114040",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "30017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Lynn Marbrey
• Rick Martin, MD
• Sara Massey, FNP-BC
• Brian McCarver, M.D.
• Gayle Marie McDonald, ATC
• Charles Daron McNatt, PHARM.D.
• Beverly Meador, MSW
• Melaro Behavioral Consultants Inc
• Christina Noel Mellenberger
• Cheryl Middleton

• Acute Care Nurse Practitioner in Henderson, TN
• Providers in Henderson, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.