Individual provider Active NPI

Donald E. R. Poisson, NPP

  • Adult Health Nurse Practitioner
  • Palm Springs, CA
National Provider Identifier
1174519508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NPP21594 Issued in RI
Practice address
1180 N Indian Canyon Dr
Suite 408
Palm Springs, CA 92262-4800
Phone
(760) 969-5200
Fax
(760) 969-5201
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NPP21594 RI Primary

Addresses

Primary practice location

1180 N Indian Canyon Dr
Suite 408
Palm Springs, CA 92262-4800

Mailing address

1180 N Indian Canyon Dr
Suite 408
Palm Springs, CA 92262-4800
Phone (760) 969-5200

Other identifiers 1

IdentifierTypeStateIssuer
213417OtherRIBLUE CROSS PROVIDER ID

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPP21594RIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Pain Care Medicine Group Inc PastSince Jan 20, 2006 Accepting new patients

Organizations & group practices 1

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174519508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "SUITE 408",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "760-969-5200",
            "fax_number": "760-969-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "SUITE 408",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "760-969-5200",
            "fax_number": "760-969-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POISSON",
        "first_name": "DONALD",
        "middle_name": "E. R.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "NPP21594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "213417",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.