NPIMap

Organization Active NPI

Mary K. McDonald MD PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hixson, TN
National Provider Identifier
1407944168
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
28536 Issued in TN
Legal business name
MARY K. MCDONALD MD PLLC
Practice address
5211 Highway 153
Suite M
Hixson, TN 37343-4956
Phone
(423) 648-7667
Fax
(423) 648-6279
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Mary K McDonald, M.D.
Title
Director Physician
Phone
(423) 648-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 28536 TN Primary

Addresses

Primary practice location

5211 Highway 153
Suite M
Hixson, TN 37343-4956

Mailing address

PO Box 22816
Chattanooga, TN 37422-2816
Phone (423) 648-7667

Other identifiers 2

IdentifierTypeStateIssuer
4097642OtherTNBLUE CROSS AND BLUE SHIELD
P00194880OtherMEDICARE RAILROAD

Other names 1

  • Pain Medicine and Rehabilitation Other name

National Provider Directory

National Provider Directory

Locations

5211 Highway 153
Ste M
Hixson, TN 37343
Phone (423) 648-7667

5211 Highway 153
Ste Z
Hixson, TN 37343

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1407944168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22816",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374222816",
            "telephone_number": "423-648-7667",
            "fax_number": "423-648-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 HIGHWAY 153",
            "address_2": "SUITE M",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434956",
            "telephone_number": "423-648-7667",
            "fax_number": "423-648-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY K. MCDONALD MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN",
        "authorized_official_telephone_number": "423-648-7667",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TN",
            "license": "28536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "4097642",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00194880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Medicine and Rehabilitation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 25, 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.