Active NPI
Monica F Donegan, PA
- Cardiovascular Disease Physician
- Coeur D Alene, ID
National Provider Identifier
1720130933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- PA105
- Practice address
- 1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814 - Phone
- (208) 667-5483
- Fax
- (208) 667-7062
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | PA105 | ID | Primary |
Addresses
Primary practice location
1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814
Mailing address
1607 Lincoln Way
Suite 200
Coeur D Alene, ID 83814-2462
Phone (208) 667-5483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 804051700 | Medicaid | ID |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA105 | ID | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220400000000",
"number": "1720130933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 LINCOLN WAY",
"address_2": "SUITE 200",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142462",
"telephone_number": "208-667-5483",
"fax_number": "208-667-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 LINCOLN WAY",
"address_2": "SUITE 200",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "83814",
"telephone_number": "208-667-5483",
"fax_number": "208-667-7062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONEGAN",
"first_name": "MONICA",
"middle_name": "F",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2008-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ID",
"license": "PA105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "804051700",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.