Caroline Lott Douglas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005678 Issued in GA

Practice address

205 Shirley Ave
Douglas, GA 31533-2327

Phone

(912) 260-5400

Fax

(912) 260-5177

NPI assigned

Oct 26, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Caroline Nancy Lott Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Medical College of Georgia School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caroline.douglas.1@9964.direct.athenahealth.com
• Direct secure messaging: caroline.douglas.2@9964.direct.athenahealth.com

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.

• CRH Physician Practices, LLC

  • Multi-Specialty Clinic/Center
  • Douglas, GA
  • NPI 1710046073
  Medicare reassignment Care Compare group
• Coffee Emergency Group LLC

  • Emergency Medicine Physician
  • Douglas, GA
  • NPI 1023353489
  Medicare reassignment
• Coffee Regional Medical Center, Inc

  • Anesthesiology Physician
  • Douglas, GA
  • NPI 1437120946
  Medicare reassignment
• Coffee Regional Medical Center

  • Clinic/Center
  • Douglas, GA
  • NPI 1992999205
  NPD
• Coffee Regional Medical Center, Inc

  • Rural Health Clinic/Center
  • Douglas, GA
  • NPI 1639211956
  NPD
• CRH Physician Practices LLC

  • Surgery Physician
  • Waycross, GA
  • NPI 1154794857
  NPD (past)

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1295061208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "31534",
            "telephone_number": "912-384-1477",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SHIRLEY AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332327",
            "telephone_number": "912-260-5400",
            "fax_number": "912-260-5177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Doctors Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332211",
            "country_code": "US",
            "telephone_number": "912-720-9010",
            "fax_number": "912-720-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CAROLINE",
        "middle_name": "LOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105371",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "005678",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "858523224F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "LOTT",
            "middle_name": "NANCY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Eddy Duncan, MD
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• Physician Assistant in Douglas, GA
• Providers in Douglas, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.