William Michael Douglas, M.A, CCC-SLP, AVT

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17530 Issued in TX

Practice address

Medical Center East South Tower 1215 21St Ave S
6422
Nashville, TN 37232-8718

Phone

(615) 875-2412

Fax

(615) 936-1225

NPI assigned

Aug 21, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1316052822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER EAST SOUTH TOWER 1215 21ST AVE S",
            "address_2": "6422",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372328718",
            "telephone_number": "615-875-2412",
            "fax_number": "615-936-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER EAST SOUTH TOWER 1215 21ST AVE S",
            "address_2": "6422",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372328718",
            "telephone_number": "615-875-2412",
            "fax_number": "615-936-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "M.A, CCC-SLP, AVT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17530",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000004920",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER I D",
            "identifier": "87464T",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005386002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenn C Douglas, MD
• Keith Douglas, MD
• Marcia Annette Douglas, MSW
• Rian Douglas
• Taneesha Douglas, CNM APRN
• Camryn Douglass, MSSW
• John Murray Douglass, DDS
• Toi Dorice Douglass
• Katharine Janke Huddleston Douillard, WHNP-BC, RN
• Allison Doulin

• Speech-Language Pathologist in Nashville, TN
• Providers in Nashville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.