Sumner B Douglas, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903149 Issued in MS

Practice address

401 Baptist Dr Ste 1040
Madison, MS 39110-2009

Phone

(601) 605-2383

Fax

(601) 605-3898

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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 MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians

Healthcare Plus Limited Liability CompanyGroup PAC ID 5698038610, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Crossgates River Oaks Hospital Hospital, Brandon, MS, CCN 250096
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• Merit Health Central Hospital, Jackson, MS, CCN 250072

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084
  Medicare reassignment Care Compare group NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465

  MS, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Winston Medical Clinic LLC

  • Rural Health Clinic/Center
  • Louisville, MS
  • NPI 1629417324
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brandon Hma LLC

  • General Acute Care Hospital
  • Brandon, MS
  • NPI 1205882669
  Care Compare affiliation
• Jackson Hma LLC

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1033163092
  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• River Oaks Hospital LLC

  • General Acute Care Hospital
  • Flowood, MS
  • NPI 1396792032
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1548821333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-226-1613",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 1040",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102009",
            "telephone_number": "601-605-2383",
            "fax_number": "601-605-3898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Broad Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395012464",
            "country_code": "US",
            "telephone_number": "228-575-1775",
            "fax_number": "228-575-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SUMNER",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madina C Dixon, NP
• Brenda B Donald, LCSW, BCD
• Vanessa Dorado, M.S., OTR/L, SLP-A
• Morgan Ariel Doty Moody, APRN
• Shekela Douglas, PMHNP
• Tracey Lamar Douglas, DMD
• Dra Health Services LLC
• Austin Drake, LAT, ATC
• Emily Melissa Draper, PHARMD
• DSL Inc

• Family Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.
• 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.