Individual provider Active NPI

David Donnelly, ATC, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1699226753
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004896RX Issued in OH
Practice address
4460 Red Bank Rd
Cincinnati, OH 45227
Phone
(513) 791-5200
Fax
(513) 791-5229
NPI assigned
Oct 24, 2016
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004896RX OH Primary

Addresses

Primary practice location

4460 Red Bank Rd
Cincinnati, OH 45227

Mailing address

4460 Red Bank Rd
Cincinnati, OH 45227-2172
Phone (513) 791-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170112002866 OH Practitioner - Physician Assistant 7517249246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christ Hospital Orthopedic Associates III LLCGroup PAC ID 8820282924, 33 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 221-5500

580 Buttermilk Pike
Crescent Springs, KY 41017-1635
Phone (859) 341-6654

608 Reading Rd
Mason, OH 45040-3001
Phone (513) 221-5500

7567 Central Parke Blvd
A
Mason, OH 45040-6852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC Physician Assistant CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Physician Assistant CurrentSince Jan 1, 2017 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Jan 1, 2017 Accepting new patients
Christ Hospital Orthopedic Associates LLC Physician Assistant Past Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

4450 Eastgate Blvd
Ste 300
Cincinnati, OH 45245
Phone (513) 981-4202

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: ddonnelly246837@direct.bsmhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1699226753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 RED BANK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452272172",
            "telephone_number": "513-791-5200",
            "fax_number": "513-791-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 RED BANK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45227",
            "telephone_number": "513-791-5200",
            "fax_number": "513-791-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "DAVID",
        "credential": "ATC, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-24",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004896RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.