Peter Gordon McDougall, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E8068 Issued in TX

Practice address

6609 Crooked Stick Dr
Ste 290
Fort Worth, TX 76132

Phone

(817) 307-5101

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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 TX

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

Interoperability endpoints

• Direct secure messaging: peter.mcdougall.1@12556.direct.athenahealth.com

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.

• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1548264948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 CROOKED STICK DR",
            "address_2": "STE 290",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-307-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 CROOKED STICK DR",
            "address_2": "STE 290",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-307-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGALL",
        "first_name": "PETER",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "E8068",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E8068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan McDonald
• Suzanne McDonald, REGISTERED NURSE
• Taylor McDonald
• Amy McDougall
• Mary McDougall
• Tiffany Lanee McDow, APRN-CNP
• Jasmine McDowell, DO
• Mitchell McDowell
• Trevette McDuffie, LCSW
• Jada Alina McElroy, LPC-A

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.