Mary Donovan, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP024542 Issued in PA

Practice address

770 Miles Rd
West Chester, PA 19380-1950

Phone

(610) 436-8611

NPI assigned

Oct 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Children'S Hospital of Philadelphia

  • Pediatrics Physician
  • Erdenheim, PA
  • NPI 1831262732
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1902560980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 CHARLES ELLIS DR",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190731313",
            "telephone_number": "862-222-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MILES RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801950",
            "telephone_number": "610-436-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "MARY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP024542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Donahue, PTA
• Tamara Rausa Donatelli, D.O.
• Gangyi Dong, OM
• Erin Nicole Donnelly, PTA
• Beth B Donovan, LPCMH
• Alyssa Katherine Donze
• Richard Donze, D.O.
• Taylor Joyce Dorrin, OTR/L
• Mary Kathleen Dougherty-Hunt, LPC
• Alexandra Dougherty

• Pediatric Nurse Practitioner in West Chester, PA
• Providers in West Chester, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.