Douglas William McKibbin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101035838 Issued in VA

Practice address

70 Medical Center Cir
Suite 308
Fishersville, VA 22939-2273

Phone

(540) 932-5909

Fax

(540) 932-5910

NPI assigned

Aug 31, 2006

Last updated

Jul 18, 2013By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1447362090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR",
            "address_2": "SUITE 308",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-932-5909",
            "fax_number": "540-932-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR",
            "address_2": "SUITE 308",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-932-5909",
            "fax_number": "540-932-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBIN",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101035838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7305117",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah H McCown, CNM
• Jay A. McDonald, M.D.
• Kara McGill-Meeks, RD
• Sarah E McGill, NP
• Rachel Anne McGirl
• William Blake McKibbin, M.D.
• Kathryn Elliot McKinney, MSN, CNM, APRN
• Robert W. McMahon, MD
• Mary G. McMasters
• Daniel Burnes McMillan, M.D.

• Specialist in Fishersville, VA
• Providers in Fishersville, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.