Susan M Douglas, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01052790A Issued in IN

Practice address

3601 4TH St
Lubbock, TX 79430-0002

Phone

(806) 743-6759

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Anesthesiology

Education

University of Louisville School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdouglas307940@direct.hfhs.org
• Direct secure messaging: sdouglas6@direct.iuhealth.org

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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD
• Gulf Shore Anesthesia Associates PA

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1902862147
  NPD (past)

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

• Indiana University Health Arnett Inc

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1699703975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-6759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Greenbush St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479042477",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01052790A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "000000207857",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64041742",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - DEACONESS GATEWAY",
            "identifier": "000000501000",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300010735",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000001146552",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdouglas6@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 Greenbush St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479042477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Double Spectrum, Inc.
• Douglas a Lampkin MD PA
• Heather Michaela Douglas, PA-C
• Lillie Douglas, RBT
• Reata Gene Douglas, LMSW
• Daniel David Douglass, FNP
• Lauren Douglass
• Lola Lashay Douglass, OD
• Breanna Douma, RBT
• Dovetail Physical Therapy and Wellness PLLC

• Anesthesiology Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.