Wade G Douglas, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME120744 Issued in FL

Practice address

1401 Centerville Road
Suite 100
Tallahassee, FL 32308-3656

Phone

(850) 877-5183

Fax

(850) 656-1288

NPI assigned

Mar 25, 2006

Last updated

Aug 19, 2014By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wade.douglas.1@5867.direct.athenahealth.com
• Direct secure messaging: wadedouglas@tmhpp.allscriptsdirect.net
• Direct secure messaging: wdouglas21589@tallahasseememorial.direct-ci.com

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.

• Doctors Memorial Hospital Inc

  dba DMH Physicians Group

  • Surgery Physician
  • Perry, FL
  • NPI 1285709451
  Medicare reassignment NPD
• Doctors Memorial Hospital Inc

  • Critical Access Hospital
  • Perry, FL
  • NPI 1427092006
  NPD
• Doctors Memorial Hospital Inc

  • Family Medicine Physician
  • Perry, FL
  • NPI 1578327896
  NPD
• Madison County Hospital Health Systems, Inc.

  dba Madison County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Madison, FL
  • NPI 1083684856
  NPD
• Madison County Hospital Health Systems, Inc.

  dba Madison County Memorial Hospital

  • Critical Access Hospital
  • Madison, FL
  • NPI 1104821461
  NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  NPD
• Tallahassee Memorial Healthcare Inc

  • Internal Medicine Physician
  • Tallahassee, FL
  • NPI 1487932422
  NPD
• Doctors Memorial Hospital Inc

  dba DMH Family Medicine

  • Rural Health Clinic/Center
  • Mayo, FL
  • NPI 1487613121
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1689634388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE ROAD",
            "address_2": "SUITE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323083656",
            "telephone_number": "850-877-5183",
            "fax_number": "850-656-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE ROAD",
            "address_2": "SUITE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323083656",
            "telephone_number": "850-877-5183",
            "fax_number": "850-656-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WADE",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21963",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME120744",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "WV",
            "license": "21963",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002707",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64102411",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2586732",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Nichole Doss, CRNA
• Jason Doss, APRN
• Michael Dottorelli, O.T.
• Cynthia P Douglas, CFM
• Tanya Douglas
• Michael L Douso, MD
• Michael Anthony Dow, L.M.T.
• Jessica Shadae Dowd
• Chandra Yvonne Dowdell, LMT
• Angela L Dowdy

• Surgery Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.