MR. WILLIAM S JR. DONNELL (M.D.) – Family Medicine Physician, NPI 1639191125

MR. WILLIAM S JR. DONNELL (M.D.) is a healthcare provider. based in Bolivar, Missouri. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 36276 (MO). The NPI Number for MR. WILLIAM S JR. DONNELL (M.D.) is 1639191125

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
MR. WILLIAM S JR. DONNELL (M.D.)
NPI
1639191125
Phone
(417) 326-6021
Address
1240 N BUTTERFIELD RD
Enumeration Date
24 July 2006
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4173286040
Graduation Year
1979 (47 years ago)
PAC ID
3870401730
Group Practice PAC ID
4183528169
Professional Enrollment ID
I20120120000178
Address ID
MO656133099BO1500XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,330 FAMILY PRACTICE in MO

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Provider Addresses for MR. WILLIAM S JR. DONNELL (M.D.)

  • North Butterfield Road, Bolivar, Polk County, Missouri, 65613, United States

    BOLIVAR, MO 656133016

    Phone: (417) 326-6021

    Fax: (417) 326-6347

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 55 Open Payments records for all available years, with a total value of $924.

Total Amount is formed as General ($924) + Research ($0) + Ownership ($0) = $924.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Lilly USA, LLC ($132).

Total Amount

$924

General + Research + Ownership

Payments

55

Total payment records

General Amount

$924

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120120000178IFamily PracticeMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65613)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183528169View full group profile
NameSpecialtyState
Family PracticeMO
-MO
-MO
Urology, Internal MedicineMO
-MO
Dermatology, Micrographic Dermatologic Surgery (Mds), DermatologyMO
Hospitalist, Internal MedicineKS
Cardiovascular Disease (Cardiology)MO
Nurse PractitionerMO
Diagnostic RadiologyMO

Reviews

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Frequently asked questions

How do I look up MR. WILLIAM S JR. DONNELL (M.D.) by NPI?
Use NPI 1639191125 when you need to reference MR. WILLIAM S JR. DONNELL (M.D.) in forms, claims, or directories.
Is MR. WILLIAM S JR. DONNELL (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MR. WILLIAM S JR. DONNELL (M.D.)'s specialty in plain language?
Clinically, the directory lists MR. WILLIAM S JR. DONNELL (M.D.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place MR. WILLIAM S JR. DONNELL (M.D.)?
The snapshot lists Bolivar, Missouri for MR. WILLIAM S JR. DONNELL (M.D.); download NPPES for the complete set.
Is MR. WILLIAM S JR. DONNELL (M.D.) a real provider?
This page reflects official NPPES data for NPI 1639191125. Always confirm identity and privileges with the practice and licensing boards.

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