Martin K. Douglas, OT

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

366 Issued in WV

Practice address

313 Maccorkle Ave SW
Charleston, WV 25303-1263

Phone

(304) 744-2300

Fax

(304) 744-5891

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1417976283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5890",
            "fax_number": "740-446-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MACCORKLE AVE SW",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253031263",
            "telephone_number": "304-744-2300",
            "fax_number": "304-744-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MARTIN",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WV",
            "license": "366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417976283",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000217",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000217244",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janie Dotson
• Kelley Ann Dotson, PA-C
• Stoney Dotson
• Hollene Lynn Doub
• Alison D Douglas
• Thomas R Douglass, M.D.
• Sarah Doutt
• Alisha Dawn Dowdy, LPN
• Brittany Nicole Dowdy, LSW
• Monique Dowell

• Occupational Therapy Assistant in Charleston, WV
• Providers in Charleston, WV by specialty
• Occupational Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.