Active NPI
Donald G Prouty
Doing business as Ithaca Family Practice
- Family Medicine Physician
- Ithaca, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- DONALD G PROUTY
- Doing business as
- Ithaca Family Practice
- Practice address
- 820 N Pine River St
Ithaca, MI 48847-1118 - Phone
- (989) 875-3722
- Fax
- (989) 875-3732
- NPI assigned
- Aug 20, 2025
- Last updated
- Aug 20, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donald Graham Prouty, MD
- Title
- Owner
- Phone
- (989) 875-4465
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
820 N Pine River St
Ithaca, MI 48847-1118
Mailing address
820 N Pine River St
Ithaca, MI 48847-1118
Phone (989) 875-3722
Other names 1
- Ithaca Family Practice
National Provider Directory
National Provider Directory- Tax ID family
- Donald G Prouty
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
820 N Pine River St
Ithaca, MI 48847
Phone (989) 875-3722
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Ithaca, MI
- NPI 1194765198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755648000000",
"number": "1164309175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 N PINE RIVER ST",
"city": "ITHACA",
"state": "MI",
"postal_code": "488471118",
"telephone_number": "989-875-3722",
"fax_number": "989-875-3732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 N PINE RIVER ST",
"city": "ITHACA",
"state": "MI",
"postal_code": "488471118",
"telephone_number": "989-875-3722",
"fax_number": "989-875-3732"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONALD G PROUTY",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-20",
"last_updated": "2025-08-20",
"certification_date": "2025-07-17",
"status": "A",
"authorized_official_last_name": "PROUTY",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "GRAHAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "989-875-4465",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ithaca Family Practice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ithaca, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.