Individual provider Active NPI

Michael McDonald, DNP, FNP-BC, BSN, RN

  • Family Nurse Practitioner
  • Enterprise, OR
National Provider Identifier
1205186509
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201608201NP-PP Issued in OR
Practice address
306 W North St
Enterprise, OR 97828-1041
Phone
(541) 426-7171
NPI assigned
Sep 13, 2012
Last updated
Apr 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201608201NP-PP OR Primary
Registered Nurse 163W00000X 201242494RN OR

Addresses

Primary practice location

306 W North St
Enterprise, OR 97828-1041

Mailing address

603 Medical Pkwy
Enterprise, OR 97828-5124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170424000883 OR Practitioner - Nurse Practitioner 9537445754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Medical Pkwy
Enterprise, OR 97828-5124
Phone (541) 426-5460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201242494RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wallowa County Health Care District CurrentSince Aug 1, 2024 Accepting new patients
Wallowa County Health Care District Current Accepting new patients
Wallowa County Health Care District CurrentSince Aug 1, 2024 Accepting new patients
Wallowa County Health Care District Past Accepting new patients
Wallowa County Health Care District Past Accepting new patients

Locations

306 W North St
Enterprise, OR 97828
Phone (541) 426-7171

601 Medical Pkwy
Enterprise, OR 97828
Phone (541) 426-3111

603 Medical Pkwy
Enterprise, OR 97828
Phone 54142645025933

Interoperability endpoints

  • Direct secure messaging: mmcdonald746164@wm.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1205186509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MEDICAL PKWY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978285124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281041",
            "telephone_number": "541-426-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MICHAEL",
        "credential": "DNP, FNP-BC, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201608201NP-PP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201242494RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, OR

Sources for this page

Verify at the official NPI Registry.