Derek Michael Donovan, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DR.0067052 Issued in CO

Practice address

300 W Ottley Ave
Fruita, CO 81521-2118

Phone

(970) 858-2119

Fax

(970) 858-2743

NPI assigned

Apr 23, 2015

Sex

Male

Sole proprietor

No

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.

• Valley View Hospital Association

  • Emergency Care Clinic/Center
  • Glenwood Springs, CO
  • NPI 1114654795

  CO, Emergency Medicine

  Medicare reassignment NPD
• Valley View Hospital Association

  • Urgent Care Clinic/Center
  • Glenwood Springs, CO
  • NPI 1790397008

  CO

  Medicare reassignment NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198

  Emergency Medicine, NH

  Medicare reassignment NPD
• Pathology Assoc of the Roaring Fork

  • Anatomic Pathology & Clinical Pathology Physician
  • Glenwood SPGS, CO
  • NPI 1386624203
  NPD
• Valley View Hospital Association

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Carbondale, CO
  • NPI 1457235202
  NPD
• Valley View Hospital Association

  • Surgery Physician
  • Glenwood SPGS, CO
  • NPI 1518353218
  NPD

Medicare fee-for-service enrollment

Enrolled in NH, CO2 enrollments

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 1, 2021.

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1902293376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815210130",
            "telephone_number": "970-858-2186",
            "fax_number": "970-858-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W OTTLEY AVE",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212118",
            "telephone_number": "970-858-2119",
            "fax_number": "970-858-2743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Belmont Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Brattleboro",
            "state": "VT",
            "postal_code": "053013498",
            "country_code": "US",
            "telephone_number": "802-257-0341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "DEREK",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0067052",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "18856",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033088",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3112479",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randi Marie Denton
• Devries Accessibility Solutions LLC
• Nicholas Devries
• Diane Dill, MD
• Dillon Companies LLC
• Dr. Tyler H. Jolley, DMD PC Doing Business As Jolley Smiles
• John David Draminski, MD
• Lisa Draminski
• Lorrie Lee Etenburn, CST/CFA
• Extra Mile Service

• All providers in Fruita, CO
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.