Individual provider Active NPI

Douglas W Moreland, D.O.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Vero Beach, FL
National Provider Identifier
1841422797
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
OS 10340 Issued in FL
Practice address
1705 19TH PL Ste E2
Vero Beach, FL 32960-0688
Phone
(772) 257-5995
Fax
(772) 257-5962
NPI assigned
Aug 11, 2009
Last updated
Apr 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Anesthesiology) Physician 207LA0401X OS 10340 FL
Addiction Medicine (Family Medicine) Physician 207QA0401X OS10340 FL
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X OS 10340 FL Primary

Addresses

Primary practice location

1705 19TH PL Ste E2
Vero Beach, FL 32960-0688

Mailing address

1705 19TH PL Ste E2
Vero Beach, FL 32960-0688
Phone (772) 257-5995

Other identifiers 1

IdentifierTypeStateIssuer
002902500MedicaidFL

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3234OKMDOptometrist
OS 10340FLMDAddiction Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ctca Physicans Group of Oklahoma, Inc Past Accepting new patients
Van Buren Hma Inc Past Accepting new patients
Anesthesiologists of Bartlesville Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dmoreland7790@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1841422797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 19TH PL STE E2",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600688",
            "telephone_number": "772-257-5995",
            "fax_number": "772-257-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 19TH PL STE E2",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600688",
            "telephone_number": "772-257-5995",
            "fax_number": "772-257-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "FL",
            "license": "OS 10340",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "OS10340",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "OS 10340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002902500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.