Individual provider Active NPI

Whitney Donaldson

  • Family Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1700412046
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.021044 Issued in IL
Practice address
304 W Hay St Ste 213
Decatur, IL 62526-4169
Phone
(217) 876-6640
NPI assigned
Mar 18, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.021044 IL Primary

Addresses

Primary practice location

304 W Hay St Ste 213
Decatur, IL 62526-4169

Mailing address

2120 N 27TH St
Decatur, IL 62526-2191

Other practice location 1

2120 N 27th St
Decatur, IL 62526-2191
Phone (217) 663-6901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200813000993 IL Practitioner - Nurse Practitioner 4486070091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

304 W Hay St
213 DMH Millennium Pain Center
Decatur, IL 62526-4169
Phone (217) 876-6640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.021044ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital CurrentSince May 2, 2023 Accepting new patients
Millennium Pain Center LLC CurrentSince Jul 6, 2020 Accepting new patients

Locations

1015 S Mercer Ave
Bloomington, IL 61701
Phone (309) 662-0088

2 Memorial Dr
Decatur, IL 62526
Phone (217) 872-2943

304 W Hay St
Ste 213
Decatur, IL 62526
Phone (217) 875-1518

2120 N 27th St
Decatur, IL 62526
Phone (217) 423-4300

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

Organizations & group practices 2

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": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1700412046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 N 27TH ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W HAY ST STE 213",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264169",
            "telephone_number": "217-876-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 N 27th St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625262191",
            "country_code": "US",
            "telephone_number": "217-663-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "WHITNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.