Active NPI
Erik Christian McDonald, PTA
- Physical Therapy Assistant
- Johnson City, TN
National Provider Identifier
1669630125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0000003480
- Practice address
- 313 Princeton Rd
Johnson City, TN 37601-2000 - Phone
- (423) 282-5435
- NPI assigned
- May 30, 2008
- 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 Therapy Assistant | 225200000X | 0000003480 | TN | Primary |
Addresses
Primary practice location
313 Princeton Rd
Johnson City, TN 37601-2000
Mailing address
313 Princeton Rd
Johnson City, TN 37601-2000
Phone (423) 282-5435
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 |
|---|---|---|---|
| 0000003480 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1669630125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 PRINCETON RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376012000",
"telephone_number": "423-282-5435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 PRINCETON RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376012000",
"telephone_number": "423-282-5435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "ERIK",
"middle_name": "CHRISTIAN",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-30",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "0000003480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.