Active NPI
Douglas Alexander Jury, DO
- Emergency Medicine Physician
- Colton, CA
National Provider Identifier
1326733205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20A25245
- Practice address
- 400 N Pepper Ave Ste 1M107
Colton, CA 92324-1819 - Phone
- (909) 580-2159
- NPI assigned
- Apr 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 20A25245 | CA | Primary |
Addresses
Primary practice location
400 N Pepper Ave Ste 1M107
Colton, CA 92324-1819
Mailing address
101 The City Dr S
Orange, CA 92868-3201
Other practice location 1
101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7890
Medicare participation
Medicare enrollment files- 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
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
100 Falls Canyon Rd
Avalon, CA 90704-2990
PO Box
Orange, CA 92863
PO Box
Suite 14091
Orange, CA 92863-1491
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A25245 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1326733205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 THE CITY DR S",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE STE 1M107",
"city": "COLTON",
"state": "CA",
"postal_code": "923241819",
"telephone_number": "909-580-2159"
}
],
"practiceLocations": [
{
"address_1": "101 The City Dr S",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928683201",
"country_code": "US",
"telephone_number": "714-456-7890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JURY",
"first_name": "DOUGLAS",
"middle_name": "ALEXANDER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-07",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A25245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.