Individual provider Active NPI

Abbie McDonald

  • Physical Therapist
  • South Daytona, FL
National Provider Identifier
1679862536
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1196510 Issued in TX
Practice address
917 Beville Rd
Suite G
South Daytona, FL 32119-1712
Phone
(386) 756-4395
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1196510 TX Primary

Addresses

Primary practice location

917 Beville Rd
Suite G
South Daytona, FL 32119-1712

Mailing address

5905 Sugar Hill Dr
Houston, TX 77057-1953
Phone (281) 732-0055

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1196510TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1679862536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SUGAR HILL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770571953",
            "telephone_number": "281-732-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BEVILLE RD",
            "address_2": "SUITE G",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191712",
            "telephone_number": "386-756-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ABBIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1196510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.