NPIMap

Organization Active NPI

Ear Nose & Throat Associates MD PA

  • Otolaryngology Physician
  • Fort Myers, FL
National Provider Identifier
1609960954
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR NOSE & THROAT ASSOCIATES MD PA
Practice address
9711 Commerce Center CT
Suite 101
Fort Myers, FL 33908-3817
Phone
(239) 939-2621
Fax
(239) 939-3875
NPI assigned
Oct 3, 2006
Last updated
Sep 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
John Drummond Donaldson, MD
Title
President Physician
Phone
(239) 939-2621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

9711 Commerce Center CT
Suite 101
Fort Myers, FL 33908-3817

Mailing address

9711 Commerce Center CT
Suite 101
Fort Myers, FL 33908-3817
Phone (239) 939-2621

Other identifiers 1

IdentifierTypeStateIssuer
268721600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090306000573 FL Part B Supplier - Clinic/Group Practice 2567528011 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

9711 Commerce Center Ct
#10
Fort Myers, FL 33908
Phone (239) 939-2621

9711 Commerce Center Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 939-2621

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1609960954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 COMMERCE CENTER CT",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083817",
            "telephone_number": "239-939-2621",
            "fax_number": "239-939-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 COMMERCE CENTER CT",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083817",
            "telephone_number": "239-939-2621",
            "fax_number": "239-939-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT ASSOCIATES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DRUMMOND",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "239-939-2621",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268721600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.