Active NPI
Crystal G Donders, DO
- General Practice Physician
- Fort Irwin, CA
National Provider Identifier
1194318741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5101026966
- Practice address
- 306 North Loop Rd
Fort Irwin, CA 92310 - Phone
- (760) 383-5289
- NPI assigned
- Feb 15, 2021
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 5101026966 | MI | Primary |
Addresses
Primary practice location
306 North Loop Rd
Fort Irwin, CA 92310
Mailing address
306 Langford Lake Rd Unit 10095
Fort Irwin, CA 92310-9800
Phone (248) 214-4449
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101026966 | MI | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1194318741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 LANGFORD LAKE RD UNIT 10095",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "923109800",
"telephone_number": "248-214-4449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 NORTH LOOP RD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "760-383-5289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONDERS",
"first_name": "CRYSTAL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-15",
"last_updated": "2023-06-29",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "5101026966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.