Mark B Douthit, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

11195A Issued in WY

Practice address

2301 House Ave Ste 301B
Cheyenne, WY 82001-3176

Phone

(307) 778-1849

Fax

(307) 778-4995

NPI assigned

Oct 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CO, WY2 enrollments

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 2

Specialty

Cardiac SurgeryAlso: Vascular Surgery

Education

Baylor College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868

  Surgery

  Medicare reassignment Care Compare group NPD
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260

  Thoracic Surgery (Cardiothoracic Vascular Surgery), WY

  Medicare reassignment NPD
• Boulder Valley Thoracic and Cardiovascular Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Longmont, CO
  • NPI 1730267949
  NPD (past) Authorized official
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  NPD
• Poudre Valley Health Care,Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1891837738
  NPD
• Boulder Community Health

  • Primary Care Clinic/Center
  • Boulder, CO
  • NPI 1740837137
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1073172201
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1124518113
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1144397134
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1154030732
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Fountain, CO
  • NPI 1295225274
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1316506231
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1407532559
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1518526441
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1538958400
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1578053567
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1598324428
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1629746599
  Care Compare affiliation

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1326038555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOUSE AVE STE 301B",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013176",
            "telephone_number": "307-778-1849",
            "fax_number": "307-778-4995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Rocky Mountain Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389004",
            "country_code": "US",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUTHIT",
        "first_name": "MARK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "29696",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "29696",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WY",
            "license": "11195A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01296961",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326038555",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133577400",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00970361",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Donelan, PT
• Staci Marie Doran, FNP-C
• Ashley Marie Doty
• Rebecca Douglas
• Taylor Douglas
• Samantha Dove
• Lois F Dowell
• Michelle Anne Dowling, FNP-BC
• Robert M Downey, RRT
• Janice A Downing, LPN

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.