Individual provider Active NPI

Grace Castro Dougan, M.D.

  • Pediatric Endocrinology Physician
  • Tampa, FL
National Provider Identifier
1669667556
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME108000 Issued in FL
Practice address
3001 W. Martin Luther King Jr. Blvd
3Rd Floor Medical Arts Building
Tampa, FL 33607
Phone
(813) 554-8420
Fax
(813) 554-8377
NPI assigned
Sep 13, 2007
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME108000 FL Primary

Addresses

Primary practice location

3001 W. Martin Luther King Jr. Blvd
3Rd Floor Medical Arts Building
Tampa, FL 33607

Mailing address

3001 W. Martin Luther King Jr. Blvd
3Rd Floor Medical Arts Building
Tampa, FL 33607
Phone (813) 554-8420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME108000FLMDPediatric Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1669667556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W. MARTIN LUTHER KING JR. BLVD",
            "address_2": "3RD FLOOR MEDICAL ARTS BUILDING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-554-8420",
            "fax_number": "813-554-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W. MARTIN LUTHER KING JR. BLVD",
            "address_2": "3RD FLOOR MEDICAL ARTS BUILDING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-554-8420",
            "fax_number": "813-554-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGAN",
        "first_name": "GRACE",
        "middle_name": "CASTRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME108000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.