Douglas J McGrady, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

036064415 Issued in IL

Practice address

5409 N Knoxville Ave
Peoria, IL 61614-5069

Phone

(309) 683-6151

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1578501896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60070",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294190070",
            "telephone_number": "866-759-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145069",
            "telephone_number": "309-683-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRADY",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036064415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220009330",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360644151",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie McGee
• William Franklin McGehee Jr., PT
• Jacob McGiles, DMD
• Katie McGill, CRNA
• Tara McGovern
• Christina McGrew, APN
• Jillian M McGriff, PT, DPT
• Hannah Kristine McHenry, PT, DPT
• April McIntyre, COTA/L
• Bethany McIntyre

• Anatomic Pathology & Clinical Pathology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.