Active NPI
Donald Lee McDonald, MD
- Psychiatry Physician
- West Memphis, AR
National Provider Identifier
1376568139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- E1189
- 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, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135506001 | Medicaid | AR | |
| 242806000 | Medicaid | TN | |
| 3811482 | Other | TN | MEDICARE |
| 5K644 | Other | AR | BCBS |
| 003121060 | Other | TN | BCBS |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| E1189 | AR | MD | Psychiatry Physician |
| MD27830 | TN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Strategies of Arkansas | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Memphis, AR
- NPI 1700950011
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Memphis, AR
- NPI 1528204468
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.