Active NPI
Douglas Stewart Fox
- Professional Counselor
- Johnson City, TN
National Provider Identifier
1407096746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2427
- Practice address
- 3305 Victoria CT
Johnson City, TN 37604-2201 - Phone
- (423) 502-4158
- NPI assigned
- Feb 26, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2427 | TN | Primary |
Addresses
Primary practice location
3305 Victoria CT
Johnson City, TN 37604-2201
Mailing address
3305 Victoria CT
Johnson City, TN 37604-2201
Phone (423) 502-4158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407096746 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240404002624 | TN | Practitioner - Mental Health Counselor | 8820435258 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choice Counseling, LLC | Professional | Current | Accepting new patients |
Locations
1416 S Roan St
Johnson City, TN 37601
Phone (423) 929-9959
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705622400000",
"number": "1407096746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3305 VICTORIA CT",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042201",
"telephone_number": "423-502-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 VICTORIA CT",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042201",
"telephone_number": "423-502-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "DOUGLAS",
"middle_name": "STEWART",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-26",
"last_updated": "2024-01-19",
"certification_date": "2024-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "2427",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407096746",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.