James Davis Douglass III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6741 Issued in NC

Practice address

101 Wall St
Fayetteville, NC 28301-4761

Phone

(910) 323-8254

Fax

(910) 323-2532

NPI assigned

Jan 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• James D Douglass DDS PA

  • General Practice Dentistry
  • Fayetteville, NC
  • NPI 1306902416
  NPD (past) Authorized official

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1124184239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WALL ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014761",
            "telephone_number": "910-323-8254",
            "fax_number": "910-323-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WALL ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014761",
            "telephone_number": "910-323-8254",
            "fax_number": "910-323-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "JAMES",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992191",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Lynn Doty, OPTICIAN APPRENTICE
• Frederique Audrey Doue, PHARMD
• Holly N Douglas, CNM
• Valerie N Douglas, M.S. CCC-SLP
• Veronica Jean Douglas, LICSW
• Stephanie McCorquodale Dove, DNP, FNP-C, CCRN
• Sydney Dove
• Cynthia Dovers
• Candice Renee Dowd, CRNA
• Claude Paul Dowd, D.D.S.

• General Practice Dentistry in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.