Active NPI
Reynaldo Antonio Douglas
- Addiction (Substance Use Disorder) Counselor
- Brooklyn, NY
National Provider Identifier
1801428990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1664 E 14TH St FL 5
Brooklyn, NY 11229-1155 - Phone
- (929) 273-7601
- Fax
- (718) 307-6871
- NPI assigned
- Feb 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1664 E 14TH St FL 5
Brooklyn, NY 11229-1155
Mailing address
47 McKeever PL Apt 8E
Brooklyn, NY 11225-2540
Phone (347) 845-8038
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | BROOKLYN | Health Information Exchange (HIE) | |
| CONNECT URL | BROOKLYN | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581033600000",
"number": "1801428990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 MCKEEVER PL APT 8E",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112252540",
"telephone_number": "347-845-8038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1664 E 14TH ST FL 5",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291155",
"telephone_number": "929-273-7601",
"fax_number": "718-307-6871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "REYNALDO",
"middle_name": "ANTONIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-07",
"last_updated": "2020-02-07",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "BROOKLYN",
"affiliation": "N",
"endpointDescription": "office pf practices",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1664 E 14th St Fl 5",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112291155",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "BROOKLYN",
"affiliation": "N",
"endpointDescription": "Offices of practices",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1664 E 14th St Fl 5",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112291155",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.