Eamon Michael Donovan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA23858 Issued in FL

Practice address

1897 Island Walk Way
Unit 5
Fernandina Beach, FL 32034-1948

Phone

(904) 261-4664

Fax

(904) 261-5852

NPI assigned

Feb 27, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Advance Rehabilitation & Consulting Limited Partnership

  • Durable Medical Equipment & Medical Supplies
  • Jasper, GA
  • NPI 1164115671
  NPD (past)
• Advance Rehabilitation & Consulting Limited Partnership

  • Physical Therapist
  • Saint Marys, GA
  • NPI 1235434283
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1194065243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-236-2774",
            "fax_number": "706-236-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 ISLAND WALK WAY",
            "address_2": "UNIT 5",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341948",
            "telephone_number": "904-261-4664",
            "fax_number": "904-261-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "EAMON",
        "middle_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Desilet, MS, CCC-SLP
• Philip Todd Devane, M.D.
• Diana R Twiggs MD
• Benjamin Nolan Diller, D.D.S.
• JB Donaldson Jr., BSN-RN
• Dovetail Orthopedics, LLC
• Julieann Drake, PTA
• Catherine Drew, PHD
• William Fletcher Drewry Jr., MD
• Deborah Dufresne, IMH

• Physical Therapy Assistant in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.