Active NPI
Kenneth John McDonald, LMT,NMT
- Specialist
- Wooster, OH
National Provider Identifier
1972675924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 33007814
- Practice address
- 430 N Market St
Wooster, OH 44691-3516 - Phone
- (330) 262-4445
- Fax
- (330) 262-7369
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 33007814 | OH | Primary |
Addresses
Primary practice location
430 N Market St
Wooster, OH 44691-3516
Mailing address
430 N Market St
Wooster, OH 44691-3516
Phone (330) 262-4445
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33007814 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972675924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 N MARKET ST",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446913516",
"telephone_number": "330-262-4445",
"fax_number": "330-262-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 N MARKET ST",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446913516",
"telephone_number": "330-262-4445",
"fax_number": "330-262-7369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "KENNETH",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "LMT,NMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "33007814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
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.