Kevin James Donathan, DC
Individual provider Active NPI Nutrition Chiropractor · Riverview, MI
NPI 1225052012 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1225052012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutrition Chiropractor 111NN1001X
- License
- 2301007586 (MI)
- Practice address
- 17533 Fort St
Riverview, MI 48193-6630 - Phone
- (734) 283-3200
- Fax
- (734) 283-5541
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040601000215 | MI | Practitioner - Chiropractic | 2466433891 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301007586 | MI | MD | Nutrition Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donathan Family Chiropractic PC | Nutrition | Current |
Accepting new patients |
Locations
17533 Fort St
Riverview, MI 48193
Phone (734) 281-0220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 2301007586 | MI | Yes |
Addresses
Primary practice location
17533 Fort St
Riverview, MI 48193-6630
Mailing address
17533 Fort St
Riverview, MI 48193-6630
Phone (734) 283-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4673483 | Medicaid | MI |
Other providers in Riverview, MI
- Dentistry for Children PC
- Design for Vision of Riverview LLC
- Nicole Diclaudio
- Donathan Family Chiropractic PC
- Darren Allen Donathan
- Carol Deyoub Donovan
- Douglas J Zakolski, D.O., P.C.
- Downriver Family Health PLLC
- Downriver Internal Medicine PC
- Downriver Internal Medicine, PC
All providers in Riverview, MI · Nutrition Chiropractor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.