Active NPI
John Lee McDonough, M.D.
- Obstetrics & Gynecology Physician
- Fort Campbell, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 11938
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223 - Phone
- (334) 464-2497
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 11938 | AL | |
| Obstetrics & Gynecology Physician | 207V00000X | 11938 | AL | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8148
Other practice location 1
650 Joel Dr
Fort Campbell, KY 42223
Phone (334) 464-2497
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38853 | Other | AL | BCBS PROVIDER NUMBER |
| 000038853 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11938 | AL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinch Valley Physicians Associates LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Clinch Valley Physicians Associates LLC | Current | Accepting new patients | |
| Obhg Texas Holdings, P.a. | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263
3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000
398 Clinic Rd
Cedar Bluff, VA 24609
Phone (276) 963-6600
Interoperability endpoints
- john.mcdonough@vab.hcadirect.net
- https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Richlands, VA
- NPI 1104265214
Obstetrics & Gynecology
-
- Obstetrics & Gynecology Physician
- Austin, TX
- NPI 1083917769
-
- Rural Health Clinic/Center
- Cedar Bluff, VA
- NPI 1821339540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1932168275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "270-798-8148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "334-464-2497"
}
],
"practiceLocations": [
{
"address_1": "650 Joel Dr",
"address_purpose": "LOCATION",
"city": "Fort Campbell",
"state": "KY",
"postal_code": "42223",
"country_code": "US",
"telephone_number": "334-464-2497",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "JOHN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AL",
"license": "11938",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AL",
"license": "11938",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "38853",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000038853",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.