Dale E Douglas, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD8036 Issued in TN

Practice address

701 County Services Dr
Cookeville, TN 38501-4338

Phone

(931) 528-2531

Fax

(931) 526-7451

NPI assigned

Oct 12, 2005

Last updated

Mar 8, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Tennessee

  dba Marion County Health Department

  • Public Health or Welfare Agency
  • Jasper, TN
  • NPI 1487791315
  Medicare reassignment NPD
• State of Tennessee

  dba Robertson County Health Department

  • Public Health or Welfare Agency
  • Springfield, TN
  • NPI 1316090145
  NPD
• State of Tennessee

  dba Upper Cumberland Regional Clinic

  • Public Health or Welfare Agency
  • Cookeville, TN
  • NPI 1598817017
  NPD
• Upper Cumberland Surgical Associate

  dba Vaughn N. Barnard, George Ivey, III, Dale Douglas, Kenna Williams

  • Surgery Physician
  • Cookeville, TN
  • NPI 1821086505
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1528056694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ENGLAND DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010924",
            "telephone_number": "931-528-7531",
            "fax_number": "931-520-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COUNTY SERVICES DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014338",
            "telephone_number": "931-528-2531",
            "fax_number": "931-526-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DALE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD 008036",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD8036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi A Donegan, P.A.
• Michael Donohue, CRNA
• Daniel H Donovan, MD
• Dornbier Enterprise Inc (Wellspring Family Chiropractic)
• Matthew M Dougherty, D.O.
• Dr Garrett C Shepherd (Huddleston & Shepherd Family Vision)
• Dr. Albert E. Hensel, III (Midsouth Allergy, Asthma, and Sinus Center)
• Dr. Andy Thompson
• Dr. Mark Lynn & Associates, PLLC (Visionworks Doctors of Optometry)
• Dr. Richard Dycus

• General Practice Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.