Individual provider Active NPI

Lisa Donegan, NP-C

  • Family Health Clinical Nurse Specialist
  • Baltimore, MD
National Provider Identifier
1669892691
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
R097056 Issued in MD
Practice address
5601 Loch Raven Blvd
Suite 3 North
Baltimore, MD 21239-2945
Phone
(443) 444-4923
Fax
(443) 444-4678
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X R097056 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Suite 3 North
Baltimore, MD 21239-2945

Mailing address

5601 Loch Raven Blvd
Suite 3 North
Baltimore, MD 21239-2945
Phone (443) 444-4923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150731014305 MD Practitioner - Nurse Practitioner 9638483977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Center of Maryland, PAGroup PAC ID 1153395306, 16 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-3775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Center of Maryland, PA CurrentSince Jun 20, 2015 Accepting new patients

Locations

5601 Loch Raven Blvd
#3N
Baltimore, MD 21239
Phone (410) 532-3775

5601 Loch Raven Blvd
Fl 3
Northwood, MD 21239
Phone (410) 532-3775

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7494/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lisa.donegan.1@7494.direct.athenahealth.com

Organizations & group practices 1

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1669892691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SUITE 3 NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4923",
            "fax_number": "443-444-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SUITE 3 NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4923",
            "fax_number": "443-444-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAN",
        "first_name": "LISA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "MD",
            "license": "R097056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.