Douglass Alan Jeffers, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

324 Issued in CO

Practice address

4020 Palmer Park Blvd Ste 101B
Suite 109
Colorado Springs, CO 80909-3433

Phone

(719) 577-9977

Fax

(719) 577-9911

NPI assigned

Dec 13, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Four Points Family Medical Center Inc

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1306998596
  NPD (past)
• Sunrise Health Care, PC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1164662052
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265593834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 PALMER PARK BLVD STE 101B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093433",
            "telephone_number": "719-577-9977",
            "fax_number": "719-577-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 PALMER PARK BLVD STE 101B",
            "address_2": "SUITE 109",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093433",
            "telephone_number": "719-577-9977",
            "fax_number": "719-577-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "DOUGLASS",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54358221",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PPTAN",
            "identifier": "811342",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "324",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betchina Jean Pierre
• Katelyn Jean, RBT
• Laura Nicole Jean, SLP- CF
• Margaret Jecklin
• Angelica Ochoa Jeffers, PA-C
• Trisha Jeffers, PHD
• Mallory Rose Jefferson, LPC, MA
• Jeffrey M Rayl DDS, PLLC
• Jeffrey P Jenks, MD PC
• Pualani Jeffries, PSY.D

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.