Active NPI
John Thomas Macdonald, M.D.
- Neurology with Special Qualifications in Child Neurology Physician
- Golden Valley, MN
National Provider Identifier
1306873625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 23433
- Practice address
- 4225 Golden Valley Rd
Golden Valley, MN 55422-4215 - Phone
- (763) 588-0661
- Fax
- (763) 287-2310
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 23433 | MN | Primary |
Addresses
Primary practice location
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Mailing address
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30229300 | Medicaid | WI | |
| 0501645 | Other | MN | MEDICA |
| 10534MA | Other | MN | BCBS OF MN |
| 24039 | Other | MN | AMERICA'S PPO |
| HP13882 | Other | MN | HEALTHPARTNERS |
| 0265010 | Other | MN | PREFERRED ONE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1306873625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 GOLDEN VALLEY RD",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224215",
"telephone_number": "763-588-0661",
"fax_number": "763-287-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 GOLDEN VALLEY RD",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224215",
"telephone_number": "763-588-0661",
"fax_number": "763-287-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "JOHN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MN",
"license": "23433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30229300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0501645",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "10534MA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "24039",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP13882",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "0265010",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.