Octavia Douglas

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN309164 Issued in PA

Practice address

70 Highland Park Dr
Levittown, PA 19056-1338

Phone

(908) 954-8942

NPI assigned

Jul 9, 2020

Last updated

Jul 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

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.

• Lady Bugs Compassionate Caregivers LLC

  • Home Health Agency
  • Levittown, PA
  • NPI 1346851482
  NPD Authorized official

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1376161059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 HIGHLAND PARK DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190561338",
            "telephone_number": "908-954-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 HIGHLAND PARK DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190561338",
            "telephone_number": "908-954-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "OCTAVIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN309164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Dittes, RN IBCLC
• Meredith Doane
• Susan Dominik, DC
• Karen Donahue
• Doris Katherine Dougherty, P.T.
• Gregory Dowling, DPT
• Dr. Bill Obrien
• Dr. Leon M. Rudolph Associates Inc.
• Dr. Mark S. Forrest
• Kyle L Dudley Sr., PSYD, MS

• Licensed Practical Nurse in Levittown, PA
• Providers in Levittown, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.