Donald Gene Mondragon II, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.055876 Issued in OH

Practice address

300 W Hospital Rd
Internal Medicine Clinic
Fort Gordon, GA 30905-5741

Phone

(706) 787-6462

Fax

(706) 787-0005

NPI assigned

Sep 5, 2006

Last updated

Oct 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1578665899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "address_2": "INTERNAL MEDICINE CLINIC",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-6462",
            "fax_number": "706-787-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "address_2": "INTERNAL MEDICINE CLINIC",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-6462",
            "fax_number": "706-787-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRAGON",
        "first_name": "DONALD",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.055876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose J. Miranda, M.D., M.P.H.
• Mark Miranda, CRNA
• Abby Christine Mitchell
• David Modlin, M.D.
• Patrick Molitor, MD
• Ron Moody, MD
• James Mooney, MD
• Charles Tyree Moore, MS, RD, LD
• Donna Elaine Moore, CRNA
• Lashawne Renee Moore, LPN

• Internal Medicine Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.