Tedd Mikel McDonald, MD

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

11898 Issued in NV

Practice address

485 W B St Ste 105
Fallon, NV 89406-2765

Phone

(775) 423-6695

Fax

(775) 423-8057

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1891798484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SANTA FE DR",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894065248",
            "telephone_number": "775-217-3095",
            "fax_number": "775-423-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 W B ST STE 105",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062765",
            "telephone_number": "775-423-6695",
            "fax_number": "775-423-8057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 East Williams Avenue",
            "address_purpose": "LOCATION",
            "city": "Fallon",
            "state": "NV",
            "postal_code": "89406",
            "country_code": "US",
            "telephone_number": "775-423-2728",
            "fax_number": "775-423-2707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TEDD",
        "middle_name": "MIKEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NV",
            "license": "11898",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NV",
            "license": "11898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Mason
• Natalie Matley Keeney, FNP
• Kenneth J Matteoni, MD
• Sharon Lynn Maxwell, PA-C, MPAS
• Thomas Vance McCormick, M.D.
• Kristina McIntyre
• Jelly McKenzie
• Michelle McKnight
• Jessica McLaren, M.S. CCC-SLP
• Karen Diane Meek, RN

• Public Health & General Preventive Medicine Physician in Fallon, NV
• Providers in Fallon, NV by specialty
• Public Health & General Preventive Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.