Individual provider Active NPI

Adam H. B. McDonald, M.A.

  • Marriage & Family Therapist
  • Jackson, CA
National Provider Identifier
1790124329
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
41528 Issued in CA
Practice address
1001 Broadway
Suite 105
Jackson, CA 95642-2649
Phone
(209) 754-9173
Fax
(209) 754-9173
NPI assigned
Jun 17, 2013
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 41528 CA Primary

Addresses

Primary practice location

1001 Broadway
Suite 105
Jackson, CA 95642-2649

Mailing address

PO Box 13
Rail Road Flat, CA 95248-0013
Phone (209) 754-9173

Other names 1

  • Buddy McDonald Other name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
41528CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1790124329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "RAIL ROAD FLAT",
            "state": "CA",
            "postal_code": "952480013",
            "telephone_number": "209-754-9173",
            "fax_number": "209-754-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY",
            "address_2": "SUITE 105",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422649",
            "telephone_number": "209-754-9173",
            "fax_number": "209-754-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ADAM",
        "middle_name": "H. B.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "41528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BUDDY",
            "last_name": "MCDONALD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.