Active NPI
Mary Donahue, PT
- Physical Therapist
- Detroit, MI
National Provider Identifier
1285778514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 261 Mack Ave
Brasza Center
Detroit, MI 48201 - Phone
- (313) 745-1100
- Fax
- (313) 745-0476
- NPI assigned
- Feb 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 5501004174 | MI | |
| Athletic Trainer | 2255A2300X | |||
| Physical Therapist | 225100000X | MI | Primary |
Addresses
Primary practice location
261 Mack Ave
Brasza Center
Detroit, MI 48201
Mailing address
261 Mack Avenue
Brasza Center
Detroit, MI 48201
Phone (313) 745-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501004174 | MI | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1285778514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 MACK AVENUE",
"address_2": "BRASZA CENTER",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-745-1100",
"fax_number": "313-745-0476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "261 MACK AVE",
"address_2": "BRASZA CENTER",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-745-1100",
"fax_number": "313-745-0476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONAHUE",
"first_name": "MARY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "MI",
"license": "5501004174",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.