Donna Marie Gaham, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703118247 Issued in MI

Practice address

799 Hombach St
Saint Ignace, MI 49781-1735

Phone

(906) 298-8000

NPI assigned

Oct 4, 2019

Last updated

Oct 4, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope Network Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Nunica, MI
  • NPI 1043295934
  NPD (past)

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1922649508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 E 12 MILE RD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497839583",
            "telephone_number": "260-312-9853",
            "fax_number": "906-984-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 HOMBACH ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811735",
            "telephone_number": "906-298-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHAM",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703118247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING LPN",
            "identifier": "4703118247",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Jay Fenchel, RN
• Elizabeth Ann Fischer
• Taylor Evan Fisher, PA
• Sarah Frankham
• Katherine Frazier
• Emily Geraghty
• April Leigh Goeschel
• Yvonne A Goudreau, CAC-M
• Courtney Grant
• Great Lakes Recovery Centers

• Licensed Practical Nurse in Saint Ignace, MI
• Providers in Saint Ignace, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.