Robert Michael Donovan, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002045 Issued in GA

Practice address

3851 Ga Highway 122
Thomasville, GA 31757

Phone

(229) 221-1707

NPI assigned

Oct 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Colquitt Family Care, Inc.

  • Clinic/Center
  • Moultrie, GA
  • NPI 1215088174
  NPD (past)

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1497942858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 GA HIGHWAY 122",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317572405",
            "telephone_number": "229-221-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 GA HIGHWAY 122",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "31757",
            "telephone_number": "229-221-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9103709",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Anissa Dix
• Doctors Anesthesia
• Gregory E Dodson, PAC
• Camille Domingo, MD
• Eric Laroy Donald
• William L Dougherty, PAC
• Valarie Michelle Dozier, D.D.S.
• James Darin Drury, M.D.
• Philip James Dubose Jr., PSY.D.
• Rachel Marie Duggar

• Physician Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.