Nicole Ann Donahue, PA

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

11425 Issued in GA

Practice address

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Phone

(404) 785-5437

NPI assigned

Jun 19, 2022

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4

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.

• Lifeline Medical Center, LLC

  • Primary Care Clinic/Center
  • Norcross, GA
  • NPI 1013321702
  NPD (past)
• Lifeline Medical Center, LLC

  • Primary Care Clinic/Center
  • Norcross, GA
  • NPI 1245658285
  NPD (past)

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

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1689305989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-785-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-19",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "11425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominion Orthopaedic Clinic, LLC
• Dominion Orthopaedic Clinic, LLC
• Dominion Partners Home Care of Atlanta LLC (ComForCare Home Care)
• Lindsey Dominique, RBT
• Don'T Go to Prison Initiative
• Donald Phillips Oral Surgery
• Donald R. Rozema DDS, PC
• Christen Donald, BCBA
• Elizabeth Harris Donald, AGACNP-BC
• Danielle Donaldson

• Pediatric Emergency Medicine (Pediatrics) Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.