Individual provider Active NPI

Donna Kathleen Milligan, PA

  • Medical Physician Assistant
  • West Plains, MO
National Provider Identifier
1619962453
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2002013040 Issued in MO
Practice address
3100 Independence SQ
West Plains, MO 65775-4235
Phone
(417) 255-1373
Fax
(417) 256-5040
NPI assigned
Sep 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2002013040 MO Primary

Addresses

Primary practice location

3100 Independence SQ
West Plains, MO 65775-4235

Mailing address

3100 Independence SQ
West Plains, MO 65775-4235
Phone (417) 255-1373

Other identifiers 1

IdentifierTypeStateIssuer
205810708MedicaidMO

Other names 1

  • Donna Kathleen Gellenthin Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000329 PA Practitioner - Physician Assistant 6800804303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2002013040MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jun 1, 2012 Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2012 Accepting new patients
Midwest Ear, Nose & Throat Clinic, P.C. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1619962453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 INDEPENDENCE SQ",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754235",
            "telephone_number": "417-255-1373",
            "fax_number": "417-256-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 INDEPENDENCE SQ",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754235",
            "telephone_number": "417-255-1373",
            "fax_number": "417-256-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIGAN",
        "first_name": "DONNA",
        "middle_name": "KATHLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2002013040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205810708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "GELLENTHIN",
            "middle_name": "KATHLEEN",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.