NPIMap

Organization Active NPI

Douglas Medical Specialist

  • Cardiovascular Disease Physician
  • Douglas, GA
National Provider Identifier
1154475085
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
024996 Issued in GA
Legal business name
DOUGLAS MEDICAL SPECIALIST
Practice address
200 Doctors Dr Ste 106
Douglas, GA 31533-2202
Phone
(912) 384-3338
Fax
(912) 383-6365
NPI assigned
Jan 22, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Cindy McNeil
Title
Office Manager
Phone
(912) 384-3338

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN101998 GA
Internal Medicine Physician 207R00000X 038423 GA
Internal Medicine Physician 207R00000X 053749 GA
Internal Medicine Physician 207R00000X 056658 GA
Cardiovascular Disease Physician 207RC0000X 024996 GA Primary

Addresses

Primary practice location

200 Doctors Dr Ste 106
Douglas, GA 31533-2202

Mailing address

200 Doctors Dr Ste 106
Douglas, GA 31533-2202
Phone (912) 384-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050902000434 GA Part B Supplier - Clinic/Group Practice 6204868862 Receives reassigned benefits from 13 practitioners
Practice locations: Douglas, GA

National Provider Directory

National Provider Directory

Locations

200 Doctors Dr
Ste N
Douglas, GA 31533
Phone (912) 384-3338

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154475085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE 106",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332202",
            "telephone_number": "912-384-3338",
            "fax_number": "912-383-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE 106",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332202",
            "telephone_number": "912-384-3338",
            "fax_number": "912-383-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MEDICAL SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MCNEIL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-384-3338",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN101998",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "038423",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "053749",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "056658",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "024996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.