Organization Active NPI

J. Todd Douglas, MD, PSC

  • Family Medicine Physician
  • Morgantown, KY
National Provider Identifier
1427165869
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34188 Issued in KY
Legal business name
J. TODD DOUGLAS, MD, PSC
Practice address
205 E Ohio St
Morgantown, KY 42261-7944
Phone
(270) 526-2772
Fax
(270) 526-6323
NPI assigned
Aug 23, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Authorized official

Name
Dr. James Todd Douglas, MD
Title
President/Owner
Phone
(270) 526-2772

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7100116510 KY
Family Medicine Physician 207Q00000X 34188 KY Primary

Addresses

Primary practice location

205 E Ohio St
Morgantown, KY 42261-7944

Mailing address

PO Box 1367
205 East Ohio St
Morgantown, KY 42261-1367
Phone (270) 526-2772

Other identifiers 2

IdentifierTypeStateIssuer
64341886MedicaidKY
65903239MedicaidKY

National Provider Directory

National Provider Directory

Locations

205 E Ohio St
Morgantown, KY 42261
Phone (270) 526-2145

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1427165869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1367",
            "address_2": "205 EAST OHIO ST",
            "city": "MORGANTOWN",
            "state": "KY",
            "postal_code": "422611367",
            "telephone_number": "270-526-2772",
            "fax_number": "270-526-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E OHIO ST",
            "city": "MORGANTOWN",
            "state": "KY",
            "postal_code": "422617944",
            "telephone_number": "270-526-2772",
            "fax_number": "270-526-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. TODD DOUGLAS, MD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "270-526-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "7100116510",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "34188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64341886",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65903239",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.