Rebecca Abigail Dondanville, ATC, EDD
Individual provider Active NPI Athletic Trainer · Demorest, GA
NPI 1992873517 · NPPES record last updated Aug 29, 2018
Key facts
- NPI
- 1992873517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT002431 (GA)
- Practice address
- 1021 Central Ave
Demorest, GA 30535 - Phone
- (706) 778-8500
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL 566 | FL | MD | Athletic Trainer |
| AT002431 | GA | MD | Athletic Trainer |
| 0663 | NC | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0663 | NC | |
| Athletic Trainer | 2255A2300X | AT002431 | GA | Yes |
| Athletic Trainer | 2255A2300X | AL 566 | FL |
Addresses
Primary practice location
1021 Central Ave
Demorest, GA 30535
Mailing address
160 Mallard Pond Cir
Alto, GA 30510-3033
Phone (704) 221-1311
Other practice location 1
315 E Wilson St.
Wingate, NC 28174
Phone (704) 233-8371
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029602556 | Other | BOARD OF CERTIFICATION |
Other providers in Demorest, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.