Individual provider Active NPI

Donna J Washington-Keeling, M.D.

  • Internal Medicine Physician
  • Caro, MI
National Provider Identifier
1316969066
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DW045612 Issued in MI
Practice address
1525 W Caro Rd
Caro, MI 48723-9686
Phone
(989) 671-2100
Fax
(989) 671-2120
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DW045612 MI Primary

Addresses

Primary practice location

1525 W Caro Rd
Caro, MI 48723-9686

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Other identifiers 5

IdentifierTypeStateIssuer
DW045612OtherMISTATE LICENSE
5221891MedicaidMI
P00651228OtherMIRR MEDICARE
1689022469MedicaidMI
1659326395MedicaidMI

Other names 1

  • Donna J Washington Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050104000669 MI Practitioner - Internal Medicine 9436107794 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DW045612MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iah of Michigan, PLLC Internal Medicine CurrentSince Jan 2, 2015 Accepting new patients
State of Michigan Office of Financial Management Current Accepting new patients
Gladwin Family Care PLLC CurrentSince Dec 1, 2015 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Mar 13, 2017 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Mar 13, 2017 Accepting new patients
Northeast Michigan Community Mental Health Authority PastSince Jul 20, 2005 Accepting new patients

Locations

2040 Chambers Rd
Caro, MI 48723
Phone (989) 672-9338

1525 W Caro Rd
Caro, MI 48723
Phone (989) 672-2100

4444 W Bristol Rd
Ste 150
Flint, MI 48507
Phone (810) 230-9500

673 E Cedar Ave
Gladwin, MI 48624
Phone (734) 333-9001

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Organizations & group practices 6

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1316969066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239686",
            "telephone_number": "989-671-2100",
            "fax_number": "989-671-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON-KEELING",
        "first_name": "DONNA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "DW045612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DW045612",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5221891",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00651228",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689022469",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659326395",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "WASHINGTON",
            "middle_name": "J",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.