Diane Marie Donoghue, LICENSED

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

752 Issued in NC

Practice address

5101 Prosperity Church Rd
Charlotte, NC 28269-8732

Phone

(704) 548-9111

Fax

(704) 548-9191

NPI assigned

Nov 28, 2011

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": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1982971537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 PROSPERITY CHURCH RD",
            "address_2": "SHADS LANDING",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28269",
            "telephone_number": "704-548-9111",
            "fax_number": "704-548-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 PROSPERITY CHURCH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282698732",
            "telephone_number": "704-548-9111",
            "fax_number": "704-548-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "LICENSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Christine Donnalley, PA
• John Donnelly, PHARMD
• Megan Tudor Donnelly, D.O.
• Trevor James Donnelly, DO
• Daniel Scott Donner, MD
• Audrey A. Donovan
• Kathleen Marie Donovan
• Kylie Donovan
• Luke Donovan, PHD, ATC
• Margaret Rita Donovan

• Physical Therapy Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.