Active NPI
Kevin Thomas McDonald, ATC
- Athletic Trainer
- Hockessin, DE
National Provider Identifier
1992083059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- J3-0000394
- Practice address
- 216 Lantana Dr
Hockessin, DE 19707-8805 - Phone
- (302) 239-2800
- Fax
- (302) 239-7500
- NPI assigned
- Jul 23, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | J3-0000394 | DE | Primary |
| Athletic Trainer | 2255A2300X | RT001417A | PA |
Addresses
Primary practice location
216 Lantana Dr
Hockessin, DE 19707-8805
Mailing address
216 Lantana Dr
Hockessin, DE 19707-8805
Phone (302) 239-2800
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 |
|---|---|---|---|
| J3-0000394 | DE | MD | Athletic Trainer |
| RT001417A | PA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportscare and Rehab Management, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Wilmington, DE
- NPI 1235370552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311379200000",
"number": "1992083059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 LANTANA DR",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "197078805",
"telephone_number": "302-239-2800",
"fax_number": "302-239-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 LANTANA DR",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "197078805",
"telephone_number": "302-239-2800",
"fax_number": "302-239-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "KEVIN",
"middle_name": "THOMAS",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-23",
"last_updated": "2011-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "DE",
"license": "J3-0000394",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT001417A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hockessin, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.