Individual provider Active NPI

Ryan Donahue, FNP-C

  • Family Nurse Practitioner
  • Atascadero, CA
National Provider Identifier
1790204923
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007031 Issued in CA
Practice address
5855 Capistrano Ave Ste D
Atascadero, CA 93422-7201
Phone
(805) 466-5600
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 95007031 CA Primary

Addresses

Primary practice location

5855 Capistrano Ave Ste D
Atascadero, CA 93422-7201

Mailing address

115 Gibson Rd
Templeton, CA 93465-9510
Phone (805) 329-5559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190114003259 CA Practitioner - Nurse Practitioner 6204172190 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Dec 13, 2021 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ryan.donahuenp.p1@direct.afh.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1790204923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 GIBSON RD",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659510",
            "telephone_number": "805-329-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 CAPISTRANO AVE STE D",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934227201",
            "telephone_number": "805-466-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "RYAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.