Individual provider Active NPI

Donna G Ivery, MD

  • Obstetrics & Gynecology Physician
  • Titusville, FL
National Provider Identifier
1548371735
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME74650 Issued in FL
Practice address
4346 S Hopkins Ave
Titusville, FL 32780-6606
Phone
(321) 267-3787
Fax
(321) 267-3790
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME74650 FL Primary

Addresses

Primary practice location

4346 S Hopkins Ave
Titusville, FL 32780-6606

Mailing address

4346 S Hopkins Ave
Titusville, FL 32780-6606
Phone (321) 267-3787

Other identifiers 4

IdentifierTypeStateIssuer
272052300MedicaidFL
9727970OtherFLCIGNA
52106OtherFLBC/BS
5815623OtherFLAETNA

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 Medicine

State licenses

LicenseStateTypeSpecialty
ME74650FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ona-GYN, LLC Obstetrics & Gynecology PastSince Dec 3, 2007 Accepting new patients
North Brevard Medical Support, Inc Past Accepting new patients
Winter Haven Hospital Inc Obstetrics & Gynecology PastSince Nov 24, 2019 Accepting new patients

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1548371735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806606",
            "telephone_number": "321-267-3787",
            "fax_number": "321-267-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4346 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806606",
            "telephone_number": "321-267-3787",
            "fax_number": "321-267-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERY",
        "first_name": "DONNA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME74650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272052300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9727970",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "52106",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5815623",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.