Active NPI
Kayla K McDonald, P.T.
- Physical Therapist
- Mitchellville, MD
National Provider Identifier
1952435471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17603
- Practice address
- 12164 Central Ave
Suite 212
Mitchellville, MD 20721-1944 - Phone
- (301) 333-2703
- Fax
- (301) 333-2705
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 17603 | MD | Primary |
Addresses
Primary practice location
12164 Central Ave
Suite 212
Mitchellville, MD 20721-1944
Mailing address
1704 Pepperidge CT
Bowie, MD 20721-3031
Phone (301) 430-0369
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952435471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 PEPPERIDGE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207213031",
"telephone_number": "301-430-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12164 CENTRAL AVE",
"address_2": "SUITE 212",
"city": "MITCHELLVILLE",
"state": "MD",
"postal_code": "207211944",
"telephone_number": "301-333-2703",
"fax_number": "301-333-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "KAYLA",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "17603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mitchellville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.