Individual provider Active NPI

Donna Demann, FNP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1801848189
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
165088 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 455-5000
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 165088 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (231) 924-4200

Other practice location 1

211 W Pine Lake Dr
Newaygo, MI 49337-8029
Phone (231) 652-1631

Other practice location 2

1211 Lafayette Ave NE
Grand Rapids, MI 49505-5092
Phone (616) 336-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040520000881 MI Practitioner - Nurse Practitioner 2769473578 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
165088MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Jan 9, 2024 Accepting new patients
Pine Rest Christian Mental Health Services Nurse Practitioner CurrentSince Jan 9, 2024 Accepting new patients
Metropolitan Hospital CurrentSince May 1, 2019 Accepting new patients
Metropolitan Hospital CurrentSince May 1, 2019 Accepting new patients
Certified Emergency Medicine Specialists, PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

4055 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 252-4010

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1801848189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "231-924-4200",
            "fax_number": "231-924-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 W Pine Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Newaygo",
            "state": "MI",
            "postal_code": "493378029",
            "country_code": "US",
            "telephone_number": "231-652-1631",
            "fax_number": "231-652-1733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Lafayette Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495055092",
            "country_code": "US",
            "telephone_number": "616-336-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMANN",
        "first_name": "DONNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "165088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.