Active NPI
Robert Allen Donaldson Jr. Jr.
- Adult Companion
- Port Saint Lucie, FL
National Provider Identifier
1629802350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- D543-761-90-148-0
- Practice address
- 612 SW Hogan St
Port Saint Lucie, FL 34983-8765 - Phone
- (772) 812-4142
- NPI assigned
- Aug 27, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | D543-761-90-148-0 | FL | |
| Adult Companion | 372600000X | D543-761-90-148-0 | FL | Primary |
Addresses
Primary practice location
612 SW Hogan St
Port Saint Lucie, FL 34983-8765
Mailing address
612 SW Hogan St
Port Saint Lucie, FL 34983-8765
Phone (772) 812-4142
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1629802350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 SW HOGAN ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349838765",
"telephone_number": "772-812-4142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 SW HOGAN ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349838765",
"telephone_number": "772-812-4142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALDSON JR.",
"first_name": "ROBERT",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-27",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "FL",
"license": "D543-761-90-148-0",
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "FL",
"license": "D543-761-90-148-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.