NPIMap

Individual provider Active NPI

Courtney Jo Donahoe, DO

  • Family Medicine Physician
  • Duluth, MN
National Provider Identifier
1629698915
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
69708 Issued in MN
Practice address
330 N 8TH Ave E
Duluth, MN 55805-2024
Phone
(218) 529-9122
NPI assigned
Apr 16, 2020
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 69708 MN
Family Medicine Physician 207Q00000X 69708 MN Primary

Addresses

Primary practice location

330 N 8TH Ave E
Duluth, MN 55805-2024

Mailing address

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 529-9122

Other names 1

  • Courtney Jo Cleveland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912002690 WI Practitioner - Family Practice 4486076247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

11134 N State Rd
Hayward, WI 54843-5325
Phone (715) 634-5505

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 392-8281

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Hospital of Superior CurrentSince Aug 28, 2023 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Aug 28, 2023 Accepting new patients
The Duluth Clinic, LTD. PastSince Apr 19, 2020 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1629698915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-529-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-529-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHOE",
        "first_name": "COURTNEY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "69708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "69708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "CLEVELAND",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.