Active NPI
Mark D McDonough, MD
- Specialist
- Orlando, FL
National Provider Identifier
1386652949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME71478
- Practice address
- 4680 Millenia Plaza Way
Orlando, FL 32839-2434 - Phone
- (407) 896-4440
- Fax
- (407) 896-4410
- NPI assigned
- Aug 3, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | ME71478 | FL | Primary |
Addresses
Primary practice location
4680 Millenia Plaza Way
Orlando, FL 32839-2434
Mailing address
PO Box 540929
Orlando, FL 32854-0929
Phone (407) 896-4440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 263875400 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME71478 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1386652949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 540929",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328540929",
"telephone_number": "407-896-4440",
"fax_number": "407-896-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4680 MILLENIA PLAZA WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328392434",
"telephone_number": "407-896-4440",
"fax_number": "407-896-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME71478",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "263875400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.