Chad Richard Douglas, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OP61034280 Issued in WA

Practice address

12 S 8TH St
Yakima, WA 98901-3020

Phone

(509) 454-4143

NPI assigned

Apr 3, 2013

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

Medicare fee-for-service enrollment

Enrolled in VA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chad.douglas.p8@direct.ynhs.nextgenshare.com

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.

• Yakima Neighborhood Health Services

  dba Neighborhood Health Terrace Heights

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1750985727
  Medicare reassignment NPD
• Childrens Hospital of the Kings Daughters Inc

  dba CHKD Urgent Care

  • Urgent Care Clinic/Center
  • Chesapeake, VA
  • NPI 1578954590
  Medicare reassignment NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1225085624
  NPD
• Yakima Neighborhood Health Services

  dba Neighborhood Connections Annex

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1285456772
  NPD
• Childrens Hospital of the Kings Daughters Inc

  • Clinical Social Worker
  • Norfolk, VA
  • NPI 1467641829
  NPD
• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1598764920
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1407199920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CHAD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "1199",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP61034280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Doty
• Jill Dougherty, MA PSYCHOLOGY LMHC
• Roland Evan Dougherty, PH.D.
• Douglas & Topper PS (Yakima Oral Surgery Associates)
• Douglas Topper Wilson Miller and Bosshardt PS (Yakima Oral Surgery Associates)
• David L Douglas
• Jonathan Douglas
• Lindsey R Douglas III, DMD
• Tyler Shane Douglas, CP61119971
• Wena Lynn Dove, LMP

• Pediatrics Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.