Active NPI
Abigail Marie Douglas, RD
- Registered Dietitian
- Bend, OR
National Provider Identifier
1609232552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D-10173281
- Practice address
- 524 SE Gleneden PL
Bend, OR 97702-3637 - Phone
- (541) 241-8806
- Fax
- (541) 646-7090
- NPI assigned
- Jan 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D-10173281 | OR | Primary |
Addresses
Primary practice location
524 SE Gleneden PL
Bend, OR 97702-3637
Mailing address
524 SE Gleneden PL
Bend, OR 97702-3637
Phone (541) 241-8806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1609232552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 SE GLENEDEN PL",
"city": "BEND",
"state": "OR",
"postal_code": "977023637",
"telephone_number": "541-241-8806",
"fax_number": "541-646-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "524 SE GLENEDEN PL",
"city": "BEND",
"state": "OR",
"postal_code": "977023637",
"telephone_number": "541-241-8806",
"fax_number": "541-646-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "ABIGAIL",
"middle_name": "MARIE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-07",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-10173281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.