Individual provider Active NPI

Donna L Hines, MD

  • Pediatrics Physician
  • Hemet, CA
National Provider Identifier
1780678037
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30670 Issued in TN
Practice address
1285 S State St
Hemet, CA 92543-7976
Phone
(951) 765-1777
Fax
(866) 390-9161
NPI assigned
Sep 1, 2005
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30670 TN Primary

Addresses

Primary practice location

1285 S State St
Hemet, CA 92543-7976

Mailing address

27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661
Phone (951) 252-8588

Other identifiers 1

IdentifierTypeStateIssuer
C130260OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050210000317 TN Practitioner - Pediatric Medicine 2567413255 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meharry Health Network, PC CurrentSince Apr 7, 2024 Accepting new patients
Memphis and Shelby County Health Dept. Pediatrics Past Accepting new patients
Shelby County Government Past Accepting new patients
Pediatric Partners Medical Professional Corporation Pediatrics Past Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

438 N Cleveland St
Memphis, TN 38104
Phone (866) 364-8944

2700 Gallatin Pike
Ste A
Nashville, TN 37216
Phone (866) 364-8944

330 Wallace Rd
Ste 109
Nashville, TN 37211
Phone (615) 832-5612

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1780678037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE",
            "address_2": "SUITE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902661",
            "telephone_number": "951-252-8588",
            "fax_number": "951-252-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437976",
            "telephone_number": "951-765-1777",
            "fax_number": "866-390-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "DONNA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "30670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C130260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.