Margie Douglas

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209008390 Issued in IL

Practice address

619 E Mason St
Suite 4P57
Springfield, IL 62701-1034

Phone

(217) 788-0706

NPI assigned

Nov 17, 2010

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Prairie Cardiovascular Consultants LTD

  • Cardiovascular Disease Physician
  • Springfield, IL
  • NPI 1659539559
  NPD (past)

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1154623585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MARGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209008390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00907053",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Dooley, LCPC
• Stephanie Doolin, FNP
• Cassie A. Dorsey, ATC
• J Kevin Dorsey, M.D.
• Rolland Lee Doubleday Jr., M.D., P.E.
• Lisa M Douglass
• Jessica Dour, FNP-C
• Bailey Dow
• Victoria J. Dow, M.D.
• Raniyah Dowdell

• Adult Health Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.