Active NPI
Donna Zella Merrill, PA-C
- Physician Assistant
- Midland, MI
National Provider Identifier
1093930604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003003
- Practice address
- 4615 Eastman Avenue
Midland, MI 48642-6825 - Phone
- (989) 631-7110
- Fax
- (989) 892-7455
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003003 | MI | Primary |
Addresses
Primary practice location
4615 Eastman Avenue
Midland, MI 48642-6825
Mailing address
1913 Trailwood Cir E
Midland, MI 48642-6825
Phone (989) 832-0857
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z96017097 | Other | MI | MEDICARE PTAN |
| MERRI-0008 | Other | MI | COMP CARE |
| 2L36020 | Other | MI | HEALTH PLUS |
| P43930009 | Other | MI | MEDICARE PTAN |
| E66019086 | Other | MI | MEDICARE PTAN |
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1093930604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1913 TRAILWOOD CIR E",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486426825",
"telephone_number": "989-832-0857",
"fax_number": "989-667-9661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 EASTMAN AVENUE",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486426825",
"telephone_number": "989-631-7110",
"fax_number": "989-892-7455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "DONNA",
"middle_name": "ZELLA",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003003",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Z96017097",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMP CARE",
"identifier": "MERRI-0008",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "2L36020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "P43930009",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "E66019086",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.