Active NPI
Edward P Donahue, PT
- Physical Therapist
- Santa Maria, CA
National Provider Identifier
1437246022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT8518
- Practice address
- 2271 S. Depot Street
Santa Maria, CA 93455 - Phone
- (805) 922-0561
- NPI assigned
- Oct 6, 2006
- Last updated
- Jan 8, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8518 | CA | Primary |
Addresses
Primary practice location
2271 S. Depot Street
Santa Maria, CA 93455
Mailing address
1400 E. Church Street
Attention: Medical Staff Office
Santa Maria, CA 93454
Phone (805) 739-3954
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OOPT85180 | Other | CA | BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8518 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1437246022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E. CHURCH STREET",
"address_2": "ATTENTION: MEDICAL STAFF OFFICE",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "93454",
"telephone_number": "805-739-3954",
"fax_number": "805-739-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2271 S. DEPOT STREET",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "93455",
"telephone_number": "805-922-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONAHUE",
"first_name": "EDWARD",
"middle_name": "P",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT8518",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "OOPT85180",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.