Individual provider Active NPI

Carma JB Douglas, AGNP-BC

  • Primary Care Nurse Practitioner
  • Springfield, OR
National Provider Identifier
1699093450
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
201901675NP-PP Issued in OR
Practice address
382 S 58TH St Ste B
Springfield, OR 97478-7623
Phone
(541) 747-4858
NPI assigned
May 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 089003081RN OR
Primary Care Nurse Practitioner 363LP2300X 201901675NP-PP OR Primary

Addresses

Primary practice location

382 S 58TH St Ste B
Springfield, OR 97478-7623

Mailing address

382 S 58TH St Ste B
Springfield, OR 97478-7623
Phone (541) 747-4858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113004513 OR Order and Referring Only - Nurse Practitioner 2264677608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
089003081RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Elderhealth & Living, Corporation CurrentSince Jun 15, 2025 Accepting new patients
TSL Springfield Operating, LLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

382 S 58th St
Ste B
Springfield, OR 97478
Phone (541) 747-4858

Interoperability endpoints

  • Direct secure messaging: carma.douglas.1@11162.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11162/brand/1/csg/1/fhir/r4
  • Direct secure messaging: cdouglas476788@direct.peacehealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1699093450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S 58TH ST STE B",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974787623",
            "telephone_number": "541-747-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 S 58TH ST STE B",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974787623",
            "telephone_number": "541-747-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CARMA",
        "middle_name": "JB",
        "credential": "AGNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "089003081RN",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "201901675NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.