Gregory Edward Douglas, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C39164 Issued in CA

Practice address

9281 Office Park Cir
120
Elk Grove, CA 95758-8068

Phone

(916) 896-1650

Fax

(916) 896-1959

NPI assigned

Feb 13, 2006

Last updated

Aug 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health and Life Organization, Inc.

  dba Sacramento Community Clinic - El Camino

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1427715515

  Obstetrics & Gynecology

  NPD (past)
• Health and Life Organization, Inc.

  dba Sacramento Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1538180245
  NPD (past)
• Professional Medical Clinic for Women-Sacramento, Inc.

  • Obstetrics & Gynecology Physician
  • Sacramento, CA
  • NPI 1962519868
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1194799650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR",
            "address_2": "120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588068",
            "telephone_number": "916-896-1650",
            "fax_number": "916-896-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR",
            "address_2": "120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588068",
            "telephone_number": "916-896-1650",
            "fax_number": "916-896-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "GREGORY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C39164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C391640",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C391641",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Doss, LPCC
• Deaujane Elizabeth Dosty
• Nicole Marie Dosty
• Amiah Dotson
• Joshua M Dougan
• Mark S Douglas, DDS, MSD
• Colin Dow, MA MFT
• Jennifer L Dow, SLP
• Hannah Ruth Manaois Downing
• Dr Kingman Louie

• Obstetrics & Gynecology Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Obstetrics & Gynecology Physician in California

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