Individual provider Active NPI

Kereisha N Donegal, MD

  • Neurology Physician
  • Athens, GA
National Provider Identifier
1417568106
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
102225 Issued in GA
Practice address
2470 Daniells Bridge Rd Ste 261
Athens, GA 30606-6188
Phone
(706) 310-1805
Fax
(706) 310-9902
NPI assigned
Aug 14, 2020
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 102225 GA Primary

Addresses

Primary practice location

2470 Daniells Bridge Rd Ste 261
Athens, GA 30606-6188

Mailing address

2470 Daniells Bridge Rd Ste 261
Athens, GA 30606-6188
Phone (706) 310-1859

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625002226 GA Practitioner - Neurology 6800308727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Mary's Medical Group, Inc.Group PAC ID 7113098393, 118 clinicians

Practice addresses (Care Compare)

2470 Daniells Bridge Rd
Athens, GA 30606-6188
Phone (706) 310-1859

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102225GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Group, Inc. Multi-Specialty CurrentSince Jul 21, 2025 Accepting new patients
St Mary's Medical Group, Inc Multi-Specialty Current Accepting new patients
St. Mary's Medical Group, Inc Multi-Specialty CurrentSince Jul 21, 2025 Accepting new patients
Athens Internal Medicine PC Multi-Specialty Past Accepting new patients

Locations

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

2470 Daniells Bridge Rd
Ste 251
Athens, GA 30606
Phone (706) 310-1859

2470 Daniells Bridge Rd
Ste 261
Athens, GA 30606
Phone (706) 310-1859

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7598/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kdonegal4403408@direct.trinity-health.org
  • Direct secure messaging: kereisha.donegal.p1@direct.mmc.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1417568106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 DANIELLS BRIDGE RD STE 261",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066188",
            "telephone_number": "706-310-1859",
            "fax_number": "706-310-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 DANIELLS BRIDGE RD STE 261",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066188",
            "telephone_number": "706-310-1805",
            "fax_number": "706-310-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAL",
        "first_name": "KEREISHA",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "102225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.