Individual provider Active NPI

Dona Michelle Tuten II, NP

  • Family Nurse Practitioner
  • Bonaire, GA
National Provider Identifier
1386674612
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN140344 Issued in GA
Practice address
106 Moran Dr
Bonaire, GA 31005-5106
Phone
(478) 988-1282
Fax
(478) 988-3120
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN140344 GA Primary

Addresses

Primary practice location

106 Moran Dr
Bonaire, GA 31005-5106

Mailing address

106 Moran Dr
Bonaire, GA 31005-5106
Phone (478) 988-1282

Other identifiers 1

IdentifierTypeStateIssuer
616033987AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20060719000234 GA Practitioner - Nurse Practitioner 2769495696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Central Ga LLCGroup PAC ID 6901702059, 17 clinicians

Practice addresses (Care Compare)

6103 Rd St
Suite 202
Macon, GA 31201-3262
Phone (478) 464-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Synergetic Healings LLC PastSince Nov 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dtuten2990807@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1386674612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MORAN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055106",
            "telephone_number": "478-988-1282",
            "fax_number": "478-988-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MORAN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055106",
            "telephone_number": "478-988-1282",
            "fax_number": "478-988-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTEN",
        "first_name": "DONA",
        "middle_name": "MICHELLE",
        "name_suffix": "II",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN140344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616033987A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

Verify at the official NPI Registry.