Individual provider Active NPI

Doris Ragland, MD

  • Internal Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1760484430
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G065355 Issued in CA
Practice address
12618 Hawthorne Blvd.
Hawthorne, CA 90250-2325
Phone
(310) 263-5700
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G065355 CA Primary

Addresses

Primary practice location

12618 Hawthorne Blvd.
Hawthorne, CA 90250-2325

Mailing address

12618 Hawthorne Blvd.
Hawthorne, CA 90250
Phone (310) 263-5700

Other identifiers 1

IdentifierTypeStateIssuer
00G653550MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dragland191849@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20120202000237 CA Practitioner - Internal Medicine 6901063981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

12618 Hawthorne Blvd
Hawthorne, CA 90250-3907
Phone (310) 263-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G065355CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Providence Medical Institute Internal Medicine Current Accepting new patients
Axminster Medical Group Internal Medicine Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

11539 Hawthorne Blvd
Ste 6E
Hawthorne, CA 90250
Phone (310) 675-5370

12618 Hawthorne Blvd
Hawthorne, CA 90250
Phone (310) 263-5700

11539 Hawthorne Blvd
Fl 6
Hawthorne, CA 90250
Phone (310) 675-5370

11539 Hawthorne Blvd
Ste F
Hawthorne, CA 90250

11539 Hawthorne Blvd
Ste 6F
Hawthorne, CA 90250

4314 W Slauson Ave
Los Angeles, CA 90043
Phone (323) 293-7171

5100 W Goldleaf Cir
Fl 2
Los Angeles, CA 90056
Phone (323) 293-7171

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dragland191849@oc.providencedirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1760484430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12618 HAWTHORNE BLVD.",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-263-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12618 HAWTHORNE BLVD.",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502325",
            "telephone_number": "310-263-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGLAND",
        "first_name": "DORIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G065355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G653550",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dragland191849@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12618 Hawthorne Blvd.",
            "city": "Hawthorne",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902502325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.