Active NPI
Micah Douglass, RN, BSN
- Registered Nurse
- Plymouth Meeting, PA
National Provider Identifier
1124330089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 726181
- Practice address
- 2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047 - Phone
- (610) 834-1122
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 726181 | PA | Primary |
Addresses
Primary practice location
2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Mailing address
PO Box 8361
Philadelphia, PA 19101-8361
Phone (215) 380-5858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 726181 | PA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1124330089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8361",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191018361",
"telephone_number": "215-380-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 HICKORY RD",
"address_2": "SUITE 240",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194621047",
"telephone_number": "610-834-1122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "MICAH",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "726181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.