Individual provider Active NPI

Inna Donovan, AGNP

  • Gerontology Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1649636374
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP129458 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8000
NPI assigned
Jan 11, 2016
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129458 TX
Gerontology Nurse Practitioner 363LG0600X AP129458 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

1101 Pawnee CT
Carrollton, TX 75007-6231
Phone (214) 673-9441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204000344 TX Practitioner - Nurse Practitioner 6709180250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP129458TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Nurse Practitioner CurrentSince Jun 8, 2016 Accepting new patients
Dallas County Hospital District Nurse Practitioner CurrentSince Jun 8, 2016 Accepting new patients
Dallas County Hospital District Nurse Practitioner Current Accepting new patients

Locations

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: idonovan11662@direct.phhs.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, 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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1649636374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PAWNEE CT",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750076231",
            "telephone_number": "214-673-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "INNA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129458",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP129458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.