Active NPI
Andrew Wainwright Douglass, MS, CCC-SLP
- Speech-Language Pathologist
- Springfield, OR
National Provider Identifier
1497172837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14084
- Practice address
- 6044 Orchid LN
Springfield, OR 97478-8579 - Phone
- (541) 275-0222
- Fax
- (541) 359-4339
- NPI assigned
- Mar 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 14084 | OR | Primary |
Addresses
Primary practice location
6044 Orchid LN
Springfield, OR 97478-8579
Mailing address
PO Box 23310
Eugene, OR 97402-0427
Phone (541) 485-8521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14084 | OR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eugene Hearing & Speech Center | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1497172837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23310",
"city": "EUGENE",
"state": "OR",
"postal_code": "974020427",
"telephone_number": "541-485-8521",
"fax_number": "541-485-6159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6044 ORCHID LN",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974788579",
"telephone_number": "541-275-0222",
"fax_number": "541-359-4339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "ANDREW",
"middle_name": "WAINWRIGHT",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-24",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "14084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.