Active NPI
Richard M Donner, M.D.
- Pediatric Cardiology Physician
- Philadelphia, PA
National Provider Identifier
1679595409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- MD017514E
- Practice address
- 3401 Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1000
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD017514E | PA | |
| Pediatric Cardiology Physician | 2080P0202X | MD017514E | PA | Primary |
| Pediatrics Physician | 208000000X | 25MA03778900 | NJ | |
| Pediatric Cardiology Physician | 2080P0202X | 25MA03778900 | NJ |
Addresses
Primary practice location
3401 Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4319
Mailing address
100 N 20TH St
Suite 301
Philadelphia, PA 19103-1443
Phone (215) 567-2422
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2530805 | Medicaid | NJ | |
| 000665231 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD017514E | PA | MD | Pediatric Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1679595409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N 20TH ST",
"address_2": "SUITE 301",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191031443",
"telephone_number": "215-567-2422",
"fax_number": "215-561-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNER",
"first_name": "RICHARD",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD017514E",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "PA",
"license": "MD017514E",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA03778900",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "NJ",
"license": "25MA03778900",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2530805",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000665231",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.