Individual provider Active NPI

Kevin James Donathan, DC

  • Nutrition Chiropractor
  • Riverview, MI
National Provider Identifier
1225052012
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2301007586 Issued in MI
Practice address
17533 Fort St
Riverview, MI 48193-6630
Phone
(734) 283-3200
Fax
(734) 283-5541
NPI assigned
Jul 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 2301007586 MI Primary

Addresses

Primary practice location

17533 Fort St
Riverview, MI 48193-6630

Mailing address

17533 Fort St
Riverview, MI 48193-6630
Phone (734) 283-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000215 MI Practitioner - Chiropractic 2466433891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17533 Fort St
Riverview, MI 48193-6630
Phone (734) 283-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Donathan Family Chiropractic PC Nutrition CurrentSince Feb 1, 2005 Accepting new patients

Locations

17533 Fort St
Riverview, MI 48193
Phone (734) 283-3200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225052012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17533 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936630",
            "telephone_number": "734-283-3200",
            "fax_number": "734-283-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17533 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936630",
            "telephone_number": "734-283-3200",
            "fax_number": "734-283-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONATHAN",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "MI",
            "license": "2301007586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.