Individual provider Active NPI

Richard N Donlon, M.D.

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1285682849
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25066 Issued in TN
Practice address
4095 American Way
Suite 1
Memphis, TN 38118-8339
Phone
(901) 271-9500
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X MD0000025066 TN
Pediatrics Physician 208000000X 25066 TN
Emergency Medicine Physician 207P00000X 25066 TN Primary

Addresses

Primary practice location

4095 American Way
Suite 1
Memphis, TN 38118-8339

Mailing address

4095 American Way
Suite 1
Memphis, TN 38118-8339
Phone (901) 271-9500

Other identifiers 1

IdentifierTypeStateIssuer
3088351MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000112 TN Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Pediatric Medicine 0648252478 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000025066TNMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radar Transport LLC CurrentSince May 28, 2023 Accepting new patients
Renatus Professional Association Pediatrics Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

2670 Union Avenue Ext
Ste 915
Memphis, TN 38112
Phone (901) 352-0062

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Organizations & group practices 4

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1285682849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 AMERICAN WAY",
            "address_2": "SUITE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381188339",
            "telephone_number": "901-271-9500",
            "fax_number": "901-271-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 AMERICAN WAY",
            "address_2": "SUITE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381188339",
            "telephone_number": "901-271-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONLON",
        "first_name": "RICHARD",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TN",
            "license": "MD0000025066",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "25066",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "25066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3088351",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.