Douglas E Vick, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

02382 Issued in KY

Practice address

208 Crossfield Dr
Versailles, KY 40383-1468

Phone

(859) 873-8044

Fax

(859) 873-8045

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 10, 2013 through Jul 10, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Douglas E. Vick, DO M. Tamarin Vick, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Versailles, KY
  • NPI 1982875050
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1326261892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831468",
            "telephone_number": "859-873-8044",
            "fax_number": "859-873-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831468",
            "telephone_number": "859-873-8044",
            "fax_number": "859-873-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "KY",
            "license": "02382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Versailles Chiropractic PSC
• Versailles Family Dre PLLC
• Versailles Family Medicine, PLLC
• Versailles Independent Pharmacy, Inc.
• Versailles Internal Medicine, PLC
• Mary Tamarin Vick, DO
• Alyssa P. Vitali, LPCC
• Gary John Vitali, ED.D., NBC
• Steve T Vogelsang, MD
• Rhonda Wade

• Neuromusculoskeletal Medicine & OMM Physician in Versailles, KY
• Providers in Versailles, KY by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.