Individual provider Active NPI

Kelly Marie Donohue, D.D.S.

  • Dentist
  • Carson City, MI
National Provider Identifier
1538468699
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020348 Issued in MI
Practice address
323 W Maple St
Carson City, MI 48811-9677
Phone
(989) 584-3171
Fax
(989) 584-3013
NPI assigned
Mar 15, 2011
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020348 MI Primary

Addresses

Primary practice location

323 W Maple St
Carson City, MI 48811-9677

Mailing address

323 W Maple St
Carson City, MI 48811-9677
Phone (989) 584-3171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122002041 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0840437919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Donohue and Donohue PC PastSince Mar 1, 2011 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1538468699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W MAPLE ST",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "488119677",
            "telephone_number": "989-584-3171",
            "fax_number": "989-584-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W MAPLE ST",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "488119677",
            "telephone_number": "989-584-3171",
            "fax_number": "989-584-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHUE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, MI

Sources for this page

Verify at the official NPI Registry.