Samuel Lessley Ardis Douglas, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

34727 Issued in AL

Practice address

500 Office Park Dr Ste 400
Mountain BRK, AL 35223-2457

Phone

(205) 803-4384

Fax

(757) 953-0845

NPI assigned

May 19, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, AL2 enrollments

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 2

Specialty

Hematology/Oncology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Birmingham Hematology Oncology Assoc LLCGroup PAC ID 1557265741, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grandview Medical Center Hospital, Birmingham, AL, CCN 010104
• St Vincent's Birmingham Hospital, Birmingham, AL, CCN 010056

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdouglas589871@direct.sentara.net

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.

• Birmingham Hematology Oncology Assoc LLC

  • Hematology & Oncology Physician
  • Birmingham, AL
  • NPI 1841216389

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• DHP of Alabama PC

  • Surgery Physician
  • Birmingham, AL
  • NPI 1497187207

  Multi-Specialty

  Medicare reassignment NPD
• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment NPD
• Baptist Health System, Inc.

  dba Medical Education Faculty

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1598711616

  Multi-Specialty

  NPD (past)
• Baptist Health System, Inc.

  • Internal Medicine Physician
  • Irondale, AL
  • NPI 1821031824

  Multi-Specialty

  NPD (past)

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

• Affinity Hospital LLC

  dba Grandview Medical Center

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  Care Compare affiliation
• St. Vincent's Birmingham

  dba Ascension St. Vincent's Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1841298999
  Care Compare affiliation

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1811308257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OFFICE PARK DR STE 400",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232457",
            "telephone_number": "205-803-4384",
            "fax_number": "757-953-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OFFICE PARK DR STE 400",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232457",
            "telephone_number": "205-803-4384",
            "fax_number": "757-953-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SAMUEL",
        "middle_name": "LESSLEY ARDIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AL",
            "license": "34727",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "AL",
            "license": "34727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer W Devilleneuve, CRNP
• Deanna Claire Diaz
• Jerri Jarrard Dobelstein
• C.Calvert Dodson III, M.D.
• Kathryn Elizabeth Dorsten
• Dr James H Blanton MD
• Dr. J. Donald Carmichael PA
• Dr. Sherri M. Weissman, LLC
• Zelda Peach Driskell, LMSW
• Mark Darrell Driskill, LICSW

• Surgical Oncology Physician in Mountain BRK, AL
• Providers in Mountain BRK, AL by specialty
• Surgical Oncology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.