Lanny Douglas, APRN

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

180365-5256 Issued in CO

Practice address

400 East Horsetooth Rd
Suite 307
Fort Collins, CO 80525

Phone

(970) 556-4502

Fax

(970) 493-5131

NPI assigned

Sep 26, 2006

Last updated

Aug 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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.

• Mind Over Matter Psychotherapeutics,PLLC

  • Psychiatry Physician
  • Fort Collins, CO
  • NPI 1154086619
  Medicare reassignment NPD
• Depression & Bipolar Clinic of Colorado, PLLC.

  • Adult Mental Health Clinic/Center
  • Fort Collins, CO
  • NPI 1144465642
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1427159664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271144",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805271144",
            "telephone_number": "970-556-4502",
            "fax_number": "970-493-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST HORSETOOTH RD",
            "address_2": "SUITE 307",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "970-556-4502",
            "fax_number": "970-493-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "LANNY",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "WY",
            "license": "18756.196",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CO",
            "license": "180365-5256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Dougherty
• Scarlett Dougherty
• Elissa Douglas, RN
• Kaitlin Douglas, MS, LMFT
• Kyle Douglas, LMFT
• Ryan Douglas, LCSW
• Morgan Ann Douglass, PHD
• David I Douphrate, MPT MBA
• Jocelyn Brooks Mavec Dove, MA
• Simon Peter Ferraro Dove, D.C.

• Psychiatric/Mental Health Clinical Nurse Specialist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.