Individual provider Active NPI

David Michael Donahue, NP

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1134572449
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
00241737759 Issued in VA
Practice address
3716 Melrose Ave NW
Roanoke, VA 24017-2716
Phone
(540) 362-0360
Fax
(540) 362-1448
NPI assigned
Jul 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 00241737759 VA Primary

Addresses

Primary practice location

3716 Melrose Ave NW
Roanoke, VA 24017-2716

Mailing address

3345 Forest CT BLDG 16
Roanoke, VA 24018-5074
Phone (434) 326-7409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115000679 VA Practitioner - Nurse Practitioner 5698054666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
00241737759VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Mar 23, 2020 Accepting new patients
Kuumba Community Health & Wellness Center, Inc. CurrentSince Mar 23, 2020 Accepting new patients

Locations

3716 Melrose Ave NW
Roanoke, VA 24017
Phone (540) 362-0360

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1134572449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 FOREST CT BLDG 16",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185074",
            "telephone_number": "434-326-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172716",
            "telephone_number": "540-362-0360",
            "fax_number": "540-362-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "00241737759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.