Blake Keith McDonald, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

LPT-30012 Issued in AZ

Practice address

23374 W Yuma Rd Ste 104
Buckeye, AZ 85326-3120

Phone

(623) 242-6908

NPI assigned

May 15, 2018

Sex

Male

Sole proprietor

Yes

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)

Enrolled

State licenses

Practice roles

Locations

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.

• Arizona Orthopedic Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Goodyear, AZ
  • NPI 1851490627
  NPD
• Arizona Orthopedic Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1760025621
  NPD (past)

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1306336391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23374 W YUMA RD STE 104",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263120",
            "telephone_number": "623-242-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23374 W YUMA RD STE 104",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263120",
            "telephone_number": "623-242-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BLAKE",
        "middle_name": "KEITH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "LPT-30012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Michael Maule, DDS
• Max Homecare LLC
• Dawn Michelle Maxwell, FNP-C
• Rosemary T Mayordo, FOSTER HOME
• Victoria Violet McBerty, FNP-BC
• Chelsea A McManamy
• Susan McMillan
• Ryan Dean McNeely
• William Brant McNew, DDS
• Chelsea Mead, PTA

• Physical Medicine & Rehabilitation Physician in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.