Individual provider Active NPI

Jeffrey Allen Donohue

  • Family Medicine Physician
  • Canton, GA
National Provider Identifier
1639100480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
046540 Issued in GA
Practice address
3755 Sixes Rd
Suite 202
Canton, GA 30114-7842
Phone
(770) 720-1880
Fax
(770) 704-7162
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 046540 GA Primary

Addresses

Primary practice location

3755 Sixes Rd
Suite 202
Canton, GA 30114-7842

Mailing address

3755 Sixes Rd
Suite 202
Canton, GA 30114-7842
Phone (770) 720-1880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110317000457 GA Practitioner - Family Practice 7618980053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3755 Sixes Rd
Canton, GA 30114-7842
Phone (770) 720-1880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046540GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2012 Accepting new patients
K Loor Medical LLC Family Medicine CurrentSince May 26, 2022 Accepting new patients
Wellstar Medical Group, LLC Family Medicine CurrentSince Dec 1, 2012 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

1750 Marietta Hwy
Ste 250
Canton, GA 30114
Phone (678) 880-9990

3755 Sixes Rd
Ste 202
Canton, GA 30114
Phone (770) 720-1880

3755 Sixes Rd
Canton, GA 30114
Phone (404) 395-0890

1120 Wellstar Way
Ste 204
Holly Springs, GA 30114
Phone (470) 267-0110

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • Direct secure messaging: jdonohue31814@directwellstar.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639100480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-720-1880",
            "fax_number": "770-704-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-720-1880",
            "fax_number": "770-704-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHUE",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "046540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.