MARK JEFFREY MCDONALD (NPI# 1114075892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114075892 |
| Entity Type | Individual |
| Full Name | MARK JEFFREY MCDONALD |
| Credential | A.T.C. |
| Practice Address |
15777 Northline Rd Suite 102 Southgate MI 48195-2385 |
| Practice Telephone | 7342468125 |
| Practice Fax Number | 7342468113 |
| Mailing Telephone | 7342468125 |
| Mailing Fax Number | 7342468113 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407140106 | Mark W Mcdonald | Emergency Medicine | 629 Winding Brook Ln, Tyler, TX 75703-0832 | 2011-05-31 |
| 1093795122 | Mark Newton Mcdonald | Dentist | Bldg 2441 21st Street, Usa Dentac, Fort Campbell, KY 42223-5369 | 2006-01-17 |
| 1861479479 | Mark C Mcdonald | Physician Assistant | 8700 W Watertown Plank Rd, Orthopaedic Surgery, Milwaukee, WI 53226 | 2005-12-23 |
| 1366837429 | Mark M Mcdonald | Psychiatry & Neurology | 1221 Lee Street, Charlottesville, VA 22908-0816 | 2015-04-05 |
| 1861818494 | Mark Mcdonald | Physical Therapist | 1450 Route 208, Wallkill, NY 12589-3799 | 2014-03-06 |
| 1386078061 | Mark Mcdonald | Counselor | 1202 S James Campbell Blvd, Ste 7a, Columbia, TN 38401-5193 | 2013-08-29 |
| 1750632048 | Mark Zachary Mcdonald | Physical Therapist | 1114 W Jackson St, Ozark, MO 65721-9164 | 2012-09-26 |
| 1144408287 | Mark William Mcdonald | Radiology | 1365 Clifton Rd Ne, Suite A1341, Atlanta, GA 30322-1013 | 2008-01-31 |
| 1770766305 | Mark E Mcdonald | Adult Companion | 2908 Ne Killingsworth St, Portland, OR 97211-6812 | 2007-12-05 |
| 1114116506 | Mark Mcdonald | Psychiatry & Neurology | 11500 W Olympic Blvd, Suite 426, Los Angeles, CA 90064-1524 | 2007-10-22 |
| Street Address |
15777 NORTHLINE RD SUITE 102 |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376542035 | Farah Iftikhar | Family Medicine | 15777 Northline Rd, Southgate, MI 48195-2385 | 2005-07-15 |
| 1427559814 | Piotr Mariusz Orawiec | Physical Therapist | 15777 Northline Rd, Southgate, MI 48195-2385 | 2018-02-22 |
| 1417495524 | Diane Pearl | Nurse Practitioner | 15777 Northline Rd, Southgate, MI 48195-2385 | 2017-02-09 |
| 1689990384 | Sheila Sungurlu | Internal Medicine | 15777 Northline Rd, Southgate, MI 48195-2385 | 2010-04-20 |
| 1033432232 | Oakwood Ambulatory, LLC | Nurse Practitioner | 15777 Northline Rd, Southgate, MI 48195-2385 | 2010-03-03 |
| 1669657367 | Oakwood Healthcare Inc | Pharmacy | 15777 Northline Rd, Ste 100a, Southgate, MI 48195-2385 | 2008-01-02 |
| 1790967339 | Southgate Urgent Care PC | Clinic/Center | 15777 Northline Rd, Suite 101, Southgate, MI 48195-2385 | 2007-12-05 |
| 1659585206 | Paul Malick | Family Medicine | 15777 Northline Rd, Southgate, MI 48195-2385 | 2007-05-10 |
| 1760525125 | Jeffrey A Kline | Specialist/Technologist | 15777 Northline Rd, Sports Medicine, Southgate, MI 48195-2385 | 2007-02-15 |
| 1801944582 | William Pugh | Specialist/Technologist | 15777 Northline Rd, Southgate, MI 48195-2385 | 2007-01-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026318 | Audrey Newstead | Specialist/Technologist | 13272 Kerr St, Southgate, MI 48195-1108 | 2020-09-03 |
| 1598814840 | Stacy Marie Gutierrez | Specialist/Technologist | 14349 Leroy St, Southgate, MI 48195-2066 | 2007-01-09 |
| 1760525125 | Jeffrey A Kline | Specialist/Technologist | 15777 Northline Rd, Sports Medicine, Southgate, MI 48195-2385 | 2007-02-15 |
| 1801944582 | William Pugh | Specialist/Technologist | 15777 Northline Rd, Southgate, MI 48195-2385 | 2007-01-08 |
| 1598813842 | Lisa Marie Hendrixon | Specialist/Technologist | 15777 Northline Rd, Southgate, MI 48195-2385 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467052027 | Brianna Redmond | Specialist/Technologist | 2145 Sunset Ln, Saginaw, MI 48604-2443 | 2020-10-31 |
| 1386243913 | Carrie A Lindsay | Specialist/Technologist | 4761 Highland Rd, Waterford, MI 48328-1178 | 2020-10-24 |
| 1528667128 | Bethany Lynn York | Specialist/Technologist | 1461 Crest Rd, Gladwin, MI 48624-7606 | 2020-10-23 |
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1427656040 | Travis Zaborowski | Specialist/Technologist | 2412 W 4th Ave, Sault Sainte Marie, MI 49783-1212 | 2020-10-15 |
| 1730787912 | Batoul Kassem | Specialist/Technologist | 6045 Steadman St, Dearborn, MI 48126-2052 | 2020-10-11 |
| 1801493697 | Janelle Dorsey | Specialist/Technologist | 24311 Ithaca St, Oak Park, MI 48237-1788 | 2020-10-05 |
| 1194332379 | Bryan Keith Baines Sr. | Specialist/Technologist | 4333 John R Rd, Troy, MI 48085-3681 | 2020-09-30 |
| 1205443553 | Emma Weber | Specialist/Technologist | 7776 Percheron St, Kalamazoo, MI 49009-5990 | 2020-09-29 |
| 1295342616 | Margaret Ann Gilbeau | Specialist/Technologist | 38051 Metro Villa Dr Unit 114f, Harrison Township, MI 48045-3553 | 2020-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.