Active NPI
Tommy R McDonald Jr.
- Mental Health Counselor
- Panama City, FL
National Provider Identifier
1619481298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH14328
- Practice address
- 1940 Harrison Ave
Panama City, FL 32405-4542 - Phone
- (850) 763-0017
- Fax
- (850) 532-6454
- NPI assigned
- Nov 19, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH14328 | FL | Primary |
Addresses
Primary practice location
1940 Harrison Ave
Panama City, FL 32405-4542
Mailing address
1940 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 763-0017
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH14328 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511049600000",
"number": "1619481298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 HARRISON AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054542",
"telephone_number": "850-763-0017",
"fax_number": "850-532-6454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 HARRISON AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054542",
"telephone_number": "850-763-0017",
"fax_number": "850-532-6454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "TOMMY",
"middle_name": "R",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-19",
"last_updated": "2017-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH14328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.