William Glen Douglas, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G46175 Issued in CA

Practice address

3701 J St Ste 201
Sacramento, CA 95816-5542

Phone

(916) 454-2345

NPI assigned

Feb 26, 2009

Last updated

Sep 12, 2022By 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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elica Health CentersGroup PAC ID 4385706845, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wdouglas342993@direct.ochin.org

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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853

  General Practice

  Medicare reassignment Care Compare group NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1740660703
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD
• Innova Pharmacy II

  • Community/Retail Pharmacy
  • Sacramento, CA
  • NPI 1124647011
  NPD (past)

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1477793727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WILLIAM",
        "middle_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G46175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Douglas
• Melissa Douglas
• Nilka E. Douglas
• Rebecca Douglas, LCSW
• Scott Jackson Douglas, MD
• Charisse Elizabeth Douglass
• Danielle Douglass, APCC
• Gordon Ladd Douglass, D.D.S.
• Brandi Renee Dour, L.C.S.W.
• Brooke Doutherd

• General Practice Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.