Donald R. Douglas, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

26259 Issued in KY

Practice address

2537 Larkin Rd
Lexington, KY 40503-3201

Phone

(270) 554-5114

Fax

(270) 215-4834

NPI assigned

Sep 13, 2006

Last updated

Jun 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Donald Douglas,MD

  dba Bluegrass Interventional Therapies

  • Pain Clinic/Center
  • Lexington, KY
  • NPI 1902329436
  NPD Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1053416313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 CHINKAPIN DRIVE",
            "address_2": "STE 2",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356",
            "telephone_number": "859-223-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 LARKIN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033201",
            "telephone_number": "270-554-5114",
            "fax_number": "270-215-4834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Prosperous Pl",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091882",
            "country_code": "US",
            "telephone_number": "859-271-3114",
            "fax_number": "859-271-0220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "733 Chinkapin Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403566023",
            "country_code": "US",
            "telephone_number": "859-312-5751",
            "fax_number": "859-223-0721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DONALD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "26259",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "26259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA PIN",
            "identifier": "611369666",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2000319",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000108104",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U. S. DOL",
            "identifier": "164291501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64262595",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUEGRASS FAMILY HEALTH",
            "identifier": "F14766",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Dougherty, M.D.
• Mark J Dougherty, MD
• Natasha Dougherty, ARNP
• Sarah Miller Dougherty, PA-C
• Brittany Douglas
• Joseph Douglas
• Mellanie Douglas
• Necole Lashalle Douglas
• Rodricka Douglas, PBT(ASCP)
• Hannah Douglass, MS, CF-SLP

• Physical Medicine & Rehabilitation Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Physical Medicine & Rehabilitation Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.

Verify at the official NPI Registry.