Kim Douglas

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT10201 Issued in FL

Practice address

7830 Pine Forest Rd
Cottage a
Pensacola, FL 32526-8404

Phone

(850) 741-6715

Fax

(850) 204-0489

NPI assigned

Aug 3, 2017

Last updated

Jul 13, 2023By the provider in NPPES

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

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Action Therapy Group LLC

  • Physical Therapist
  • Jay, FL
  • NPI 1548861602

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1548785249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E BOBE ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325033962",
            "telephone_number": "850-741-6715",
            "fax_number": "850-204-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 PINE FOREST RD",
            "address_2": "COTTAGE A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325268404",
            "telephone_number": "850-741-6715",
            "fax_number": "850-204-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Moreno St",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325012316",
            "country_code": "US",
            "telephone_number": "850-434-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corazon V Dotlich, ARNP
• William D Doty, MD
• Douglas Reynolds OD PA (Gulf Coast Vision Center)
• Douglas W. Arnett D.D.S. P.a.
• Erica F. Douglas, MSA
• Sergio F Douglas, PHARM. D.
• Lori Lynn Douglass
• John Lucien Dours, DMD
• Hillary H. Doussan, PA-C
• Pamela Lee Downey I, LMHC

• Occupational Therapist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.