Organization Active NPI

Donna M O'Neill M.D. P.C.

  • Infectious Disease Physician
  • Jackson, MI
National Provider Identifier
1770796567
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
DONNA M O'NEILL M.D. P.C.
Practice address
1100 E Michigan Ave
Suite 305
Jackson, MI 49201-1847
Phone
(517) 788-4781
Fax
(517) 788-4799
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Peggy L Johnson, RN
Title
Office Manager
Phone
(517) 788-4781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1100 E Michigan Ave
Suite 305
Jackson, MI 49201-1847

Mailing address

1100 E Michigan Ave
Suite 305
Jackson, MI 49201-1847
Phone (517) 788-4781

Other identifiers 1

IdentifierTypeStateIssuer
2992806MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050829000802 MI Part B Supplier - Clinic/Group Practice 2264463272 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Locations

1100 E Michigan Ave
Ste 305
Jackson, MI 49201
Phone (517) 788-4781

214 N Elm Ave
Jackson, MI 49202
Phone (517) 788-4781

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770796567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 305",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-788-4781",
            "fax_number": "517-788-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 305",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-788-4781",
            "fax_number": "517-788-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA M O'NEILL M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-788-4781",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2992806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.