Individual provider Active NPI

Jean P Donahue, MD

  • Dermatopathology Physician
  • Jasper, AL
National Provider Identifier
1720088743
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
00020327 Issued in AL
Practice address
1606 Highway 78 W
Jasper, AL 35501-3668
Phone
(205) 295-9415
Fax
(205) 295-9418
NPI assigned
Aug 1, 2005
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 00020327 AL Primary

Addresses

Primary practice location

1606 Highway 78 W
Jasper, AL 35501-3668

Mailing address

PO Box 6230
Wheeling, WV 26003-0722
Phone (304) 242-7107

Other identifiers 1

IdentifierTypeStateIssuer
000035603MedicaidAL

Other names 1

  • Jean Pierre Donahue Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000677 AL Practitioner - DermatologyPractitioner - Pathology 2961467352 Practice locations: Jasper, AL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00020327ALMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Dermatology and Rejuvenation Center PC CurrentSince May 22, 2022 Accepting new patients
Dermatology Services LLC Dermatopathology CurrentSince Jan 17, 2022 Accepting new patients

Locations

1606 Highway 78 W
Jasper, AL 35501
Phone (205) 295-9145

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.

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1720088743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6230",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030722",
            "telephone_number": "304-242-7107",
            "fax_number": "304-242-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 HIGHWAY 78 W",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355013668",
            "telephone_number": "205-295-9415",
            "fax_number": "205-295-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "JEAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AL",
            "license": "00020327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000035603",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "DONAHUE",
            "middle_name": "PIERRE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.