Ellen Donaldson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4061 Suzanne Dr Ste Candd
Diberville, MS 39540-3735

Phone

(228) 396-4434

NPI assigned

Jan 6, 2022

Last updated

Jan 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1952062473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 VICKSBURG CT",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645934",
            "telephone_number": "228-218-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 SUZANNE DR STE CANDD",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395403735",
            "telephone_number": "228-396-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diberville Medical Spa
• Carla Diane Diffenderfer, FNP
• Shekina T Dillon, NURSE PRACTITIONER
• Sarah Sage Dolbear, M.D
• Maria Morrison Dominick, PMHNP
• Rhonda Dunaway, RPH
• Vanessa Lynn Duncombe, M.D.
• Dynamic Rehabilitation Services LLC (Neolife PT and Wellness)
• Robert Ray Ellis, DPT
• Dillion Ford Evans, DPT, CSCS

• Behavior Technician in D'Iberville, MS
• Providers in D'Iberville, MS by specialty
• Behavior Technician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.