Douglas Stewart Fitzwater, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R8N02 Issued in MO

Practice address

204 E 3Rd St
Portageville, MO 63873-1402

Phone

(573) 379-5467

Fax

(573) 379-5671

NPI assigned

Oct 26, 2005

Last updated

Aug 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Emergency Medicine, Family Practice

Education

University of Missouri, Kansas City, School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Dexter, MO, CCN 267589
• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
• Pemiscot County Memorial Hospital Hospital, Hayti, MO, CCN 260780
• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Pemiscot County Memorial Hospital

  • Emergency Care Clinic/Center
  • Hayti, MO
  • NPI 1578668661
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1194765685
  Medicare reassignment NPD
• Douglas Fitzwater

  • Family Medicine Physician
  • Caruthersville, MO
  • NPI 1467442566
  NPD (past) Authorized official
• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD
• Pemiscot County Memorial Hospital

  • Rural Acute Care Hospital
  • Hayti, MO
  • NPI 1437179710
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Caruthersville Clinic

  • Family Medicine Physician
  • Caruthersville, MO
  • NPI 1487829222
  NPD (past)
• Missouri Delta Medical Center

  dba Portageville Community Care Center

  • Rural Health Clinic/Center
  • Portageville, MO
  • NPI 1568703130
  NPD (past)
• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  NPD (past)
• Missouri Delta Medical Center

  dba New Madrid Community Care Center

  • Rural Health Clinic/Center
  • New Madrid, MO
  • NPI 1972944593
  NPD (past)
• WT Regional Medical Associates

  dba West Tennessee Medical Group Primary Care Caruthersville

  • Rural Health Clinic/Center
  • Caruthersville, MO
  • NPI 1477870467
  NPD (past)

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

• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  Care Compare affiliation
• Pemiscot County Memorial Hospital

  • Rural Acute Care Hospital
  • Hayti, MO
  • NPI 1437179710
  Care Compare affiliation
• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation
• Tri County Home Health, Inc.

  dba Elara Caring

  • Home Health Agency
  • Dexter, MO
  • NPI 1881641090
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1619967106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-7406",
            "fax_number": "573-472-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 3RD ST",
            "city": "PORTAGEVILLE",
            "state": "MO",
            "postal_code": "638731402",
            "telephone_number": "573-379-5467",
            "fax_number": "573-379-5671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Main St",
            "address_purpose": "LOCATION",
            "city": "New Madrid",
            "state": "MO",
            "postal_code": "638691513",
            "country_code": "US",
            "telephone_number": "573-748-2546",
            "fax_number": "573-748-2433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Pl",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101002",
            "country_code": "US",
            "telephone_number": "314-454-2076",
            "fax_number": "314-747-8953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "DOUGLAS",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R8N02",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "R8N02",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "R8N02",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Portageville, MO
• Providers in Portageville, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.