Individual provider Active NPI

Kelly Ann Donaldson, APN-C

  • Adult Health Nurse Practitioner
  • Midland Park, NJ
National Provider Identifier
1497811848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00112600 Issued in NJ
Practice address
44 Godwin Ave
Midland Park, NJ 07432-1969
Phone
(201) 444-5992
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00112600 NJ Primary

Addresses

Primary practice location

44 Godwin Ave
Midland Park, NJ 07432-1969

Mailing address

31 Carriage LN
West Milford, NJ 07480-1822
Phone (973) 728-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20140326001347 NJ Practitioner - Nurse Practitioner 6204067796 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
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Dec 14, 2015 Accepting new patients

Locations

1900 Union Valley Rd
Ste 303
Hewitt, NJ 07421
Phone (973) 473-5700

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

Organizations & group practices 1

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 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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497811848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CARRIAGE LN",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074801822",
            "telephone_number": "973-728-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321969",
            "telephone_number": "201-444-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00112600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

Verify at the official NPI Registry.