Individual provider Active NPI

Cheryl Anne Donahue, P.T.

  • Physical Therapist
  • Kingston, NY
National Provider Identifier
1073679361
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010192-1 Issued in NY
Practice address
111 Maiden LN
Kingston, NY 12401-4525
Phone
(845) 688-2888
Fax
(845) 688-2811
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010192-1 NY Primary

Addresses

Primary practice location

111 Maiden LN
Kingston, NY 12401-4525

Mailing address

111 Maiden LN
Kingston, NY 12401-4525
Phone (845) 246-9109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070315000462 NY Practitioner - Physical Therapist in Private Practice 7810090610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010192-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catskill Mountain Physical Therapy P.C. Physical Therapist PastSince Jun 21, 2005 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1073679361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MAIDEN LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014525",
            "telephone_number": "845-246-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MAIDEN LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014525",
            "telephone_number": "845-688-2888",
            "fax_number": "845-688-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "CHERYL",
        "middle_name": "ANNE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010192-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.