Individual provider Active NPI

Kieran Michael Donahue, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Enid, OK
National Provider Identifier
1356104129
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
203743 Issued in OK
Practice address
302 N Independence St Ste 408
Enid, OK 73701-4097
Phone
(580) 634-3317
Fax
(580) 565-1019
NPI assigned
Feb 5, 2024
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 203743 OK
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 203743 OK Primary

Addresses

Primary practice location

302 N Independence St Ste 408
Enid, OK 73701-4097

Mailing address

302 N Independence St Ste 408
Enid, OK 73701-4097
Phone (580) 634-3317

Other practice location 1

2701 W University Blvd
Durant, OK 74701-2997
Phone (580) 740-4053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250908000297 OK Practitioner - Nurse Practitioner 6709388929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homecare Advisors LLCGroup PAC ID 3173877362, 33 clinicians

Practice addresses (Care Compare)

1200 S Air Depot Blvd
Suite O
Midwest City, OK 73110-4848
Phone (405) 931-9811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
203743OKMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Homecare Advisors LLC CurrentSince Jul 31, 2025 Accepting new patients
Psychiatric Wellness Aprn-CNP PLLC PastSince Jul 1, 2025 Accepting new patients

Locations

2701 W University Blvd
Durant, OK 74701
Phone (580) 740-4053

1200 S Air Depot Blvd
Ste O
Midwest City, OK 73110
Phone (405) 931-9811

Organizations & group practices 3

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1356104129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N INDEPENDENCE ST STE 408",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014097",
            "telephone_number": "580-634-3317",
            "fax_number": "580-565-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N INDEPENDENCE ST STE 408",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014097",
            "telephone_number": "580-634-3317",
            "fax_number": "580-565-1019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 W University Blvd",
            "address_purpose": "LOCATION",
            "city": "Durant",
            "state": "OK",
            "postal_code": "747012997",
            "country_code": "US",
            "telephone_number": "580-740-4053",
            "fax_number": "918-515-6204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "KIERAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OK",
            "license": "203743",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "203743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.