William Campbell Douglass III, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME56428 Issued in FL

Practice address

400 Clyde Morris Blvd Ste a
Ormond Beach, FL 32174-8172

Phone

(386) 231-4430

NPI assigned

Mar 9, 2006

Last updated

Jul 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  NPD
• Advance Technological Radiology, PA

  • Diagnostic Radiology Physician
  • Davenport, FL
  • NPI 1154450351
  NPD (past)
• Bay View Urgent Care LLC

  • Family Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1386896991
  NPD (past)
• Emcare Physician Providers, Inc.

  • Emergency Medicine Physician
  • Punta Gorda, FL
  • NPI 1376592063
  NPD (past)
• Emcare Physician Providers, Inc.

  • Emergency Medicine Physician
  • Ormond Beach, FL
  • NPI 1629027487
  NPD (past)
• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  NPD (past)
• Emergency Physician Specialists Inc

  • Emergency Medicine Physician
  • Davenport, FL
  • NPI 1912973850
  NPD (past)
• Emergency Physicians Inc

  dba Emergency Resources Group

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  NPD (past)
• Emergency Physicians Inc

  dba Emergency Resource Group

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1396713087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748172",
            "telephone_number": "386-231-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748172",
            "telephone_number": "386-231-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "WILLIAM",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME56428",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME56428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063935400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11314",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly A Doggett, ARNP
• Barbara Dulce Donlin, COTA
• Kathleen Cecilia Dorn
• Brenda L Dornbach, LMHC
• John Douglas
• Jason Downes
• Aryana B Downs
• Rebekah Elisabeth Doyle, PA
• Dr Michael Edward Townsend MD PA
• Dr. Donald J Fornace DO Facc Inc

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.