Dianna Forrest Douglass, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

903689 Issued in MS

Practice address

152 Highway 7 S
Oxford, MS 38655-5392

Phone

(662) 234-7521

Fax

(662) 236-3071

NPI assigned

Feb 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precise Clinical Neuroscience Specialists 37 clinicians

Right Track Medical Group, Inc 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Right Track Medical Group, Inc

  • Psychiatry Physician
  • Olive Branch, MS
  • NPI 1972080257

  MS

  Medicare reassignment Care Compare group NPD
• Precise Clinical Neuroscience Specialists

  • Psychiatry Physician
  • Flowood, MS
  • NPI 1770717449

  MS

  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1043679079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 COUNTY ROAD 373",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389653740",
            "telephone_number": "662-202-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555327",
            "country_code": "US",
            "telephone_number": "662-234-7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "DIANNA",
        "middle_name": "FORREST",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MS",
            "license": "901761",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "903689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anneal Dillon, PH.D.
• Sophia Dineen
• Jennifer Dixon
• Selena Dobilas, MS
• Katrina Simmons Doss, MS, CCC-SLP
• Steven Douville, DO
• Staci Dow, BSN,RN
• Tina J Dow, M.S.
• Jewell D Downey, MA, BA, BSW
• Nyaisha Doyle, BSW, MSW

• All providers in Oxford, MS
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.