Individual provider Active NPI

Donald Lee McDonald, MD

  • Psychiatry Physician
  • West Memphis, AR
National Provider Identifier
1376568139
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E1189 Issued in AR
Practice address
309 N 5TH St
West Memphis, AR 72301-3213
Phone
(870) 732-6600
Fax
(870) 732-6621
NPI assigned
Jul 13, 2006
Last updated
Feb 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X E1189 AR Primary
Psychiatry Physician 2084P0800X MD27830 TN

Addresses

Primary practice location

309 N 5TH St
West Memphis, AR 72301-3213

Mailing address

703 Calvin Avery Dr
Suite a
West Memphis, AR 72301-6501
Phone (870) 732-1878

Other identifiers 5

IdentifierTypeStateIssuer
135506001MedicaidAR
242806000MedicaidTN
3811482OtherTNMEDICARE
5K644OtherARBCBS
003121060OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20080227000839 AR Practitioner - Psychiatry 4981693231 Reassigns benefits to 1 organization
Practice locations: West Memphis, AR

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arkansas College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

309 N 5TH St
West Memphis, AR 72301-3213
Phone (870) 732-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1189ARMDPsychiatry Physician
MD27830TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Strategies of Arkansas PastSince Dec 21, 2001 Accepting new patients

Organizations & group practices 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1376568139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 CALVIN AVERY DR",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723016501",
            "telephone_number": "870-732-1878",
            "fax_number": "870-702-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N 5TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723013213",
            "telephone_number": "870-732-6600",
            "fax_number": "870-732-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DONALD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E1189",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD27830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135506001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242806000",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3811482",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5K644",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "003121060",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.