Katherine Douglas, RD/RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

11555 Central Pkwy Ste 201
Jacksonville, FL 32224-2693

Phone

(904) 300-2809

NPI assigned

Jan 24, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1619683729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 GLENEAGLE GRANDE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321243044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242693",
            "telephone_number": "904-300-2809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Gleneagle Grande Dr",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321243044",
            "country_code": "US",
            "telephone_number": "386-852-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KATHERINE",
        "credential": "RD/RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam C Douglas
• Bethany Ann Douglas, D.M.D.
• Breanna Douglas
• Hannah Douglas, APRN
• Hannah D Douglas
• Kianna Douglas, RBT
• Mark Stephen Douglas, M.D.
• Moriah Nicole Douglas
• Theron Douglas, PHARMD
• William Douglas

• Registered Dietitian in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.