Individual provider Active NPI

Karen L. Douglas, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1295988533
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704160358 Issued in MI
Practice address
24424 W McNichols Rd
Detroit, MI 48219-3653
Phone
(313) 531-2500
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704160358 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704160358 MI Primary

Addresses

Primary practice location

24424 W McNichols Rd
Detroit, MI 48219-3653

Mailing address

510 E Ferry St
Detroit, MI 48202-3816
Phone (313) 614-9195

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200225001865 MI Practitioner - Nurse Practitioner 9335576768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Development Centers IncGroup PAC ID 0547254443, 15 clinicians

Practice addresses (Care Compare)

24424 W McNichols
Detroit, MI 48219-3653
Phone (313) 531-2500

Merit-based Incentive Payment System (MIPS)

Final score
86.64 of 100Reported as group
Quality
58.04
Promoting interoperability
91
Improvement activities
40
Cost
81.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704160358MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Development Centers, Inc. CurrentSince Jan 11, 2020 Accepting new patients
Southfield Mental Health Associates PC CurrentSince Feb 6, 2023 Accepting new patients
Focus Therapy Clinic PastSince Dec 3, 2023 Accepting new patients

Locations

17421 Telegraph Rd
Detroit, MI 48219
Phone (313) 255-0900

24424 W McNichols Rd
Detroit, MI 48219
Phone (313) 255-0900

4321 E McNichols Rd
Hamtramck, MI 48212
Phone (313) 334-6717

17141 Ryan Rd
Hamtramck, MI 48212
Phone (313) 369-1717

17320 W 12 Mile Rd
Ste 101
Southfield, MI 48076
Phone (248) 727-3456

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1295988533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E FERRY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023816",
            "telephone_number": "313-614-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24424 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193653",
            "telephone_number": "313-531-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KAREN",
        "middle_name": "L.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704160358",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704160358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.