Individual provider Active NPI

Donald Anthony Norman, MD

  • Gynecology Physician
  • Clarkston, WA
National Provider Identifier
1376866590
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD 00025406 Issued in WA
Practice address
1119 Highland Ave
Suite 6
Clarkston, WA 99403-2836
Phone
(509) 254-2722
Fax
(509) 769-2022
NPI assigned
Mar 2, 2010
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M 5392 ID
Gynecology Physician 207VG0400X MD 00025406 WA Primary

Addresses

Primary practice location

1119 Highland Ave
Suite 6
Clarkston, WA 99403-2836

Mailing address

1119 Highland Ave
Suite 6
Clarkston, WA 99403-2836
Phone (509) 254-2722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IN, ID3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120905000082 WA Practitioner - Obstetrics/Gynecology 2860649456 Reassigns benefits to 1 organization
I20210113001823 IN Practitioner - Obstetrics/Gynecology 2860649456
I20210122002406 ID Practitioner - Obstetrics/Gynecology 2860649456 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M 5392IDMDObstetrics & Gynecology Physician
MD 00025406WAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Jan 5, 2021 Accepting new patients

Locations

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1376866590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 HIGHLAND AVE",
            "address_2": "SUITE 6",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032836",
            "telephone_number": "509-254-2722",
            "fax_number": "509-769-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HIGHLAND AVE",
            "address_2": "SUITE 6",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032836",
            "telephone_number": "509-254-2722",
            "fax_number": "509-769-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "DONALD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M 5392",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "MD 00025406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

Verify at the official NPI Registry.