Kimberly Deshay Douglas, MA, MBC

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

6430 Court Rd BLDG a
Houston, TX 77053-4462

Phone

(325) 391-4168

NPI assigned

Mar 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1144978040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 RIPPLE CREEK DR",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211913",
            "telephone_number": "832-427-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 COURT RD BLDG A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770534462",
            "telephone_number": "325-391-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KIMBERLY",
        "middle_name": "DESHAY",
        "credential": "MA, MBC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2024-04-20",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David G Douglas
• Deandrea Michelle Douglas, JST
• Denika Y Douglas, L.P., L.S.S.P.
• Diana Garcia Douglas, NP
• Gloria Denice Douglas, LPC
• Kord Douglas
• Laquita Donatto Douglas, RPH
• Lissa Whyte Douglas, LPC
• Matthew Taylor Douglas, MD
• Robin Gayle Douglas, VSD, JST

• Nurse's Aide in Houston, TX
• Providers in Houston, TX by specialty
• Nurse's Aide in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.