Active NPI
Douglas A Col, PHD
- Clinical Psychologist
- Ashland, OR
National Provider Identifier
1093939944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1346
- Practice address
- 542 Washington St
Ste 200
Ashland, OR 97520 - Phone
- (541) 488-6941
- Fax
- (541) 488-6951
- NPI assigned
- Apr 12, 2007
- Last updated
- Oct 27, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1346 | OR | Primary |
Addresses
Primary practice location
542 Washington St
Ste 200
Ashland, OR 97520
Mailing address
542 Washington St
Ste 200
Ashland, OR 97520
Phone (541) 488-6941
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 295715 | Medicaid | OR | |
| R106323 | Other | OR | MEDICARE ID-PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111130000429 | OR | Practitioner - Clinical Psychologist | 1759555857 | Practice locations: Ashland, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
542 Washington St
Ashland, OR 97520-1951
Phone (541) 488-6941
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1346 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1093939944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "542 WASHINGTON ST",
"address_2": "STE 200",
"city": "ASHLAND",
"state": "OR",
"postal_code": "97520",
"telephone_number": "541-488-6941",
"fax_number": "541-488-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "542 WASHINGTON ST",
"address_2": "STE 200",
"city": "ASHLAND",
"state": "OR",
"postal_code": "97520",
"telephone_number": "541-488-6941",
"fax_number": "541-488-6951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COL",
"first_name": "DOUGLAS",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1346",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "295715",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID-PIN",
"identifier": "R106323",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.