Jessica A Dougan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3277 Issued in SC

Practice address

1624 Main St
Columbia, SC 29201-2818

Phone

(803) 454-0365

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1477914117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PLANTATION POINTE RD",
            "city": "RIDGEWAY",
            "state": "SC",
            "postal_code": "291307537",
            "telephone_number": "803-422-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 MAIN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012818",
            "telephone_number": "803-454-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGAN",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Grace Dorton
• Tasneem Dossaji, DDS
• Gregory Dotson Jr., DPT
• Nikita Dotson
• Dareen Antoun Douchi, PHARM D
• Glen N Dougherty Jr., MD
• Ariel Douglas, APRN
• Ashley Douglas, LISW
• Faun Douglas, M.ED.
• Lasheena Tindal Douglas, APRN

• Physical Therapy Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.