Individual provider Active NPI

Vincent Michael Douglas

  • Private Vehicle
  • Lancaster, CA
National Provider Identifier
1518690718
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
Practice address
1831 Trudgeon Ave
Lancaster, CA 93535-4354
Phone
(661) 202-7635
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X Primary

Addresses

Primary practice location

1831 Trudgeon Ave
Lancaster, CA 93535-4354

Mailing address

1831 Trudgeon Ave
Lancaster, CA 93535-4354
Phone (661) 202-7635

Other identifiers 1

IdentifierTypeStateIssuer
C3528136OtherCASTATE DRIVERS LICENSE

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1518690718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 TRUDGEON AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354354",
            "telephone_number": "661-202-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 TRUDGEON AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354354",
            "telephone_number": "661-202-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "VINCENT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DRIVERS LICENSE",
            "identifier": "C3528136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.