Individual provider Active NPI

Donna Petkunas Byrne

  • Occupational Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1740599281
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT23840 Issued in FL
Practice address
10560 SW Stephanie Way Apt 202
Port Saint Lucie, FL 34987-2328
Phone
(772) 238-0702
Fax
(772) 237-5823
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8788 MA
Occupational Therapist 225X00000X OT23840 FL Primary

Addresses

Primary practice location

10560 SW Stephanie Way Apt 202
Port Saint Lucie, FL 34987-2328

Mailing address

11609 SW Hawthorne Hill Rd
Port St Lucie, FL 34987-5420
Phone (508) 340-2826

Other practice location 1

2 Keewaydin Dr
Salem, NH 03079-2839
Phone (800) 995-2673 ext. 1351

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

LicenseStateTypeSpecialty
OT23840FLMDOccupational Therapist
8788MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Care Physical Therapy Occupational Therapist CurrentSince May 14, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1740599281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11609 SW HAWTHORNE HILL RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349875420",
            "telephone_number": "508-340-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 SW STEPHANIE WAY APT 202",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872328",
            "telephone_number": "772-238-0702",
            "fax_number": "772-237-5823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Keewaydin Dr",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "NH",
            "postal_code": "030792839",
            "country_code": "US",
            "telephone_number": "800-995-2673 x1351",
            "fax_number": "866-420-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETKUNAS BYRNE",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "8788",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT23840",
            "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 May 9, 2023; 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.