Dustin T Douglas, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

016194 Issued in KY

Practice address

19 Medical Loop Ste 2
Whitley City, KY 42653-4382

Phone

(606) 376-5043

Fax

(606) 376-5466

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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.

• Walgreen Co.

  • Pharmacy
  • Jamestown, TN
  • NPI 1841494820
  NPD
• Burgess Drug Store Inc

  • Long Term Care Pharmacy
  • Whitley City, KY
  • NPI 1194652412
  NPD (past)
• Burgess Drug Store Inc

  • Pharmacy
  • Stearns, KY
  • NPI 1598235996
  NPD (past)
• Burgess Drug Store Inc 3

  • Long Term Care Pharmacy
  • Stearns, KY
  • NPI 1275461329
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2024.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1649244153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 ASHLEY LN",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416060",
            "telephone_number": "423-286-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MEDICAL LOOP STE 2",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "426534382",
            "telephone_number": "606-376-5043",
            "fax_number": "606-376-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19740 Alberta St",
            "address_purpose": "LOCATION",
            "city": "Oneida",
            "state": "TN",
            "postal_code": "378413305",
            "country_code": "US",
            "telephone_number": "423-569-6633",
            "fax_number": "423-569-6932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2157 S Highway 27 Ste 2",
            "address_purpose": "LOCATION",
            "city": "Stearns",
            "state": "KY",
            "postal_code": "426476297",
            "country_code": "US",
            "telephone_number": "606-376-9662",
            "fax_number": "606-376-9658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "TN",
            "postal_code": "385564105",
            "country_code": "US",
            "telephone_number": "931-879-4884",
            "fax_number": "931-879-4955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DUSTIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0036725",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "36725",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "016194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci N. Daugherty, LPCC
• Karla Davis, CSW
• Nicky Davis, LPCC
• Kelli Chantay Dixon
• Nina Dobbs
• Ruby Carol Duncan, FNP
• Eastern Kentucky Health Care PLLC
• Tammie L Emerson-Johnson, FNP
• Family Health Care Associates 7 Limited Liability Company
• Shawn Frazee, PT, DPT

• All providers in Whitley City, KY
• Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; 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.