Mary McDonald, COTA

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

PHY T 2675 Issued in AK

Practice address

12110 Business Blvd
Suite 6 PMB 413
Eagle River, AK 99577-7725

Phone

(907) 317-9349

Fax

(866) 628-8601

NPI assigned

Dec 9, 2013

Last updated

Dec 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1790116275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 POLK RD",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476018056",
            "telephone_number": "812-480-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 BUSINESS BLVD",
            "address_2": "SUITE 6 PMB 413",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777725",
            "telephone_number": "907-317-9349",
            "fax_number": "866-628-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MARY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AK",
            "license": "PHY T 2675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige McCaffrey
• Jessica McCartney
• Marilyn McCorry
• Ashley Lyn McDonald, DPT
• Lindsey McDonald
• Susan McDonald
• Sarah McElroy
• Christina McGauthiar, LCSW, CDC I
• Marci Ann McGill, RD, LD
• Kiana Clarey McGovern

• Pediatric Occupational Therapist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Pediatric Occupational Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.