Michelle Douglas, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 9105934 Issued in FL

Practice address

5825 Highway 90
Milton, FL 32583-1763

Phone

(850) 266-3430

Fax

(850) 626-3431

NPI assigned

Apr 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth

  • Health Service Clinic/Center
  • Pensacola, FL
  • NPI 1750823233
  NPD (past)
• Southwest Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Yuma, AZ
  • NPI 1992732259
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1346202595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 PEBBLE RIDGE DR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325832305",
            "telephone_number": "619-723-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 HIGHWAY 90",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325831763",
            "telephone_number": "850-266-3430",
            "fax_number": "850-626-3431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Airport Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048622",
            "country_code": "US",
            "telephone_number": "850-549-3379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5054",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9105934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Dillon
• Jelinda Vanlora Dimick, APRN
• Christopher Dixon
• Kristi A Dixon, RN
• Shequita Marie Docken, FNP-BC
• Julia Renee Draper, M.A.
• Beni W Driskell, LMT
• Priscilla Dubret
• Dura-Med Southeast, Inc.
• Dynamic Pain & Wellness PLLC

• Medical Physician Assistant in Milton, FL
• Providers in Milton, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.