Active NPI
Donna Petkunas Byrne
- Occupational Therapist
- Port Saint Lucie, FL
National Provider Identifier
1740599281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT23840
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| OT23840 | FL | MD | Occupational Therapist |
| 8788 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Care Physical Therapy | Occupational Therapist | Current | 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.