Individual provider Active NPI

Douglas Thaggard, MD

  • Internal Medicine Physician
  • Olive Branch, MS
National Provider Identifier
1215347349
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24977 Issued in MS
Practice address
4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone
(901) 516-1290
Fax
(901) 516-1220
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 56029 TN
Hospitalist Physician 208M00000X 24977 MS
Internal Medicine Physician 207R00000X 56029 TN
Internal Medicine Physician 207R00000X 24977 MS Primary

Addresses

Primary practice location

4250 Bethel Rd
Olive Branch, MS 38654-8737

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170731002472 MS Practitioner - Hospitalist 2264651199 Reassigns benefits to 1 organization
I20170801000980 TN Practitioner - Hospitalist 2264651199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Mississippi School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Hospital & facility affiliations

  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24977MSMDInternal Medicine Physician
56029TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Inpatient Physicians LLC Internal Medicine CurrentSince Jul 31, 2017 Accepting new patients
Methodist Healthcare - Olive Branch Hospital Past Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: dthaggard25474@mlh.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1215347349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BETHEL RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAGGARD",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "56029",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "24977",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "56029",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "24977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.