Douglas J States, MD
Individual provider Active NPI Family Medicine Physician · North Platte, NE
NPI 1407899669 · NPPES record last updated Nov 17, 2009
Key facts
- NPI
- 1407899669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 19182 (NE)
- Practice address
- 209 McNeel LN
North Platte, NE 69101-6054 - Phone
- (308) 534-8383
- Fax
- (308) 534-5670
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Nebraska College of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lincoln Medical Education Partnership
Practice addresses (Care Compare)
4600 Valley Rd
Suite 200
Lincoln, NE 68510-4882
Phone (402) 483-4571
Hospital & facility affiliations
- Bryan Medical Center
- Great Plains Health
- CHI Health St. Elizabeth
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051021000309 | NE | Practitioner - Family Practice | 3072539907 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19182 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Medical Education Partnership | Family Medicine | Current |
Accepting new patients |
| Bryan Medical Center | Past | Accepting new patients | |
| Susan M Schuckert MD PC | Past | Accepting new patients |
Locations
4600 Valley Rd
Ste 200
Lincoln, NE 68510
Phone (402) 483-4571
Interoperability endpoints
- douglas.states.1@9271.direct.athenahealth.com
- douglasstates@midlandfm.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19182 | NE | Yes |
Addresses
Primary practice location
209 McNeel LN
North Platte, NE 69101-6054
Mailing address
904 Henry Avenue
North Platte, NE 69101
Phone (308) 532-5866
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025295700 | Medicaid | NE |
Other providers in North Platte, NE
- Amanda Marie Standage
- Bailey Stapleman
- Kayla Starr
- Jefrey Start
- States Family Practice LLC
- James Koopman States
- Michael J States
- Trent J States
- Phillip A Stawski
- Amelia Steck
All providers in North Platte, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.