Individual provider Active NPI

Richard Donaldson

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Hixson, TN
National Provider Identifier
1346203783
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
6961 Issued in TN
Practice address
2051B Hamill Rd
Suite 210
Hixson, TN 37343-4093
Phone
(423) 870-4400
Fax
(423) 870-8281
NPI assigned
Apr 7, 2006
Last updated
Apr 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 6961 TN Primary

Addresses

Primary practice location

2051B Hamill Rd
Suite 210
Hixson, TN 37343-4093

Mailing address

2051B Hamill Rd
Suite 210
Hixson, TN 37343-4093
Phone (423) 870-4400

Other identifiers 2

IdentifierTypeStateIssuer
4049435OtherTNBLUE CROSS BLUE SHIELD
3173936MedicaidTN

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6961TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
R. William Donaldson, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1346203783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051B HAMILL RD",
            "address_2": "SUITE 210",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434093",
            "telephone_number": "423-870-4400",
            "fax_number": "423-870-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051B HAMILL RD",
            "address_2": "SUITE 210",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434093",
            "telephone_number": "423-870-4400",
            "fax_number": "423-870-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "TN",
            "license": "6961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4049435",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3173936",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.