Active NPI
Mark Zachary McDonald, DPT
- Physical Therapist
- Ozark, MO
National Provider Identifier
1750632048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2008022379
- Practice address
- 1114 W Jackson St
Ozark, MO 65721-9164 - Phone
- (417) 581-1234
- Fax
- (888) 550-3518
- NPI assigned
- Sep 26, 2012
- Last updated
- Dec 29, 2015
- 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 Therapist | 225100000X | 2008022379 | MO | Primary |
Addresses
Primary practice location
1114 W Jackson St
Ozark, MO 65721-9164
Mailing address
1114 W Jackson St
Ozark, MO 65721-9164
Phone (417) 581-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA4370001 | Other | MO | MEDICARE PTAN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2008022379 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451347200000",
"number": "1750632048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 W JACKSON ST",
"city": "OZARK",
"state": "MO",
"postal_code": "657219164",
"telephone_number": "417-581-1234",
"fax_number": "888-550-3518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 W JACKSON ST",
"city": "OZARK",
"state": "MO",
"postal_code": "657219164",
"telephone_number": "417-581-1234",
"fax_number": "888-550-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "MARK",
"middle_name": "ZACHARY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-26",
"last_updated": "2015-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2008022379",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "MA4370001",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ozark, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.