Devorah Donnell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

61855 Issued in CT

Practice address

25 Collins Rd
Bristol, CT 06010-3893

Phone

(860) 589-8882

NPI assigned

Jun 17, 2015

Sex

Female

Sole proprietor

No

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1093196941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 INDIAN SPRING RD",
            "city": "WOODSTOCK",
            "state": "CT",
            "postal_code": "062812606",
            "telephone_number": "860-810-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COLLINS RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060103893",
            "telephone_number": "860-589-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELL",
        "first_name": "DEVORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "61855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyoung Hi Song Dickson, LMFT
• Jamie Alexandra Dingus
• Discovering Me Therapeutic Services LLC
• David Dobrzanski, MD
• Kimberley Joy Dompier, MS, RD, CD-N
• Rachel Driscoll, RD
• Lisa M Drouin
• DRS. Bencivengo & Gaudio, D.M.D.,P.C.
• Howard Gary Dubin, MD
• Joann Dudheker, APRN

• Family Medicine Physician in Bristol, CT
• Providers in Bristol, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.