NPIMap

Individual provider Active NPI

Donovan Schmidt, DO

  • Emergency Medicine Physician
  • Kingman, AZ
National Provider Identifier
1497713416
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2768 Issued in AZ
Practice address
2002 Stockton Hill Rd
Suite 103
Kingman, AZ 86401-4698
Phone
(928) 753-3303
Fax
(928) 753-3603
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2768 AZ Primary

Addresses

Primary practice location

2002 Stockton Hill Rd
Suite 103
Kingman, AZ 86401-4698

Mailing address

PO Box 3909
Kingman, AZ 86402-3909
Phone (928) 753-3303

Other identifiers 6

IdentifierTypeStateIssuer
860373636OtherAZHUMANA GROUP
3981220OtherAZEVERCARE
AZ0728670OtherAZBLUE CROSS BLUE SHIELD GR
057324MedicaidAZ
453051001OtherAZGROUP HEALTH GRP
AW1436OtherAZHEALTHNET GRP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2768AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients
Smith Tryon Family Health Inc D.B.a. Blue Water Medical PastSince Oct 27, 2011 Accepting new patients
Blue Water Internal Medicine Associates PC Past Accepting new patients
Sunset Emergency Physicians LLC Emergency Medicine PastSince Aug 17, 2025 Accepting new patients
Twin Peaks Medical Associates PLLC PastSince Sep 3, 2009 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Kingman Healthcare, Inc Past Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1497713416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3909",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864023909",
            "telephone_number": "928-753-3303",
            "fax_number": "928-753-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 STOCKTON HILL RD",
            "address_2": "SUITE 103",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014698",
            "telephone_number": "928-753-3303",
            "fax_number": "928-753-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "DONOVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "2768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GROUP",
            "identifier": "860373636",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "3981220",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057324",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH GRP",
            "identifier": "453051001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GRP",
            "identifier": "AW1436",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.