Individual provider Active NPI

Preston Donjon, PT

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1497470413
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40079 Issued in FL
Practice address
12840 Tamiami TRL N Ste 200
Naples, FL 34110-1619
Phone
(239) 592-5500
Fax
(239) 592-1614
NPI assigned
Oct 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 2022030868 MO
Physical Therapist 225100000X PT40079 FL Primary

Addresses

Primary practice location

12840 Tamiami TRL N Ste 200
Naples, FL 34110-1619

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Other practice location 1

3600 Country Club Dr Ste 530B
Jefferson City, MO 65109-1060
Phone (573) 606-7100

Other practice location 2

11172 Highway 142 N
Covington, GA 30014-2547
Phone (678) 712-3692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221101001952 MO Practitioner - Physical Therapist in Private Practice 2264809490 Reassigns benefits to 2 organizations
I20230302002467 GA Practitioner - Physical Therapist in Private Practice 2264809490 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson City Medical Group PCGroup PAC ID 1850371089, 117 clinicians

Practice addresses (Care Compare)

1225 W Stadium Blvd
Jefferson City, MO 65109-6003
Phone (573) 635-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40079FLMDPhysical Therapist
2022030868MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince Nov 1, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jan 9, 2023 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients
Outbound Rehabilitation & Wellness LLC Physical Therapist CurrentSince Oct 17, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince Nov 1, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

11172 Highway 142 N
Covington, GA 30014
Phone (678) 712-3692

2463 Hamilton Mill Pkwy
Ste 250
Dacula, GA 30019
Phone (770) 365-7876

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

277 Highway 74 N
Ste 203
Peachtree City, GA 30269
Phone (678) 364-0337

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

3600 Country Club Dr
Ste 530B
Jefferson City, MO 65109
Phone (573) 606-7100

3600 Country Club Dr
Ste 530
Jefferson City, MO 65109
Phone (573) 681-0447

1225 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-7725

1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771

1739 Elm Ct
Ste 205206
Jefferson Cty, MO 65101
Phone (573) 606-7100

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1497470413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12840 TAMIAMI TRL N STE 200",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101619",
            "telephone_number": "239-592-5500",
            "fax_number": "239-592-1614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Country Club Dr Ste 530B",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651091060",
            "country_code": "US",
            "telephone_number": "573-606-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11172 Highway 142 N",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142547",
            "country_code": "US",
            "telephone_number": "678-712-3692",
            "fax_number": "678-712-3693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONJON",
        "first_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022030868",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.