Individual provider Active NPI

Christina Douglass, M.D.

  • Family Medicine Physician
  • Rome, GA
National Provider Identifier
1265667828
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
065762 Issued in GA
Practice address
2112 Shorter Ave NW Ste 200
Rome, GA 30165-2042
Phone
(706) 233-4000
Fax
(706) 236-1913
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 065762 GA Primary

Addresses

Primary practice location

2112 Shorter Ave NW Ste 200
Rome, GA 30165-2042

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703
Phone (706) 602-7800

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110829000706 GA Practitioner - Family Practice 4183894215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Practice addresses (Care Compare)

104 Hospital Dr
Chatsworth, GA 30705-2058
Phone (706) 695-1820

Hospital & facility affiliations

  • Adventhealth Redmond Hospital, Rome, GA, CCN 110168
  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
68.23
Promoting interoperability
100
Improvement activities
40
Cost
74.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System Georgia Inc CurrentSince Feb 1, 2023 Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

104 Hospital Dr
Chatsworth, GA 30705
Phone (706) 517-2098

2112 Shorter Ave NW
Ste 200
Rome, GA 30165
Phone (706) 233-4000

Interoperability endpoints

  • Direct secure messaging: cdouglass1198273@adventhealth.direct-ci.com

Organizations & group practices 1

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 2

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1265667828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "30703",
            "telephone_number": "706-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 SHORTER AVE NW STE 200",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652042",
            "telephone_number": "706-233-4000",
            "fax_number": "706-236-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "065762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.