Jimmie L Douglass III, D.C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

2008000770 Issued in MO

Practice address

317 S Wood St
Neosho, MO 64850-1857

Phone

(417) 451-1545

Fax

(417) 451-1548

NPI assigned

Jan 28, 2008

Last updated

Jan 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Douglass Chiropractic LLC

  • Chiropractor
  • Neosho, MO
  • NPI 1023268109
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1861679383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S WOOD ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501857",
            "telephone_number": "417-451-1545",
            "fax_number": "417-451-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S WOOD ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501857",
            "telephone_number": "417-451-1545",
            "fax_number": "417-451-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "JIMMIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MO",
            "license": "2008000770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody A Dibble, PTA
• Susan Marie Dodson
• Laysie Dorman
• Sidney Douglas, OTA
• Douglass Chiropractic LLC
• Randolf J Dunn, NP
• Tamara Ebbinghaus
• Kalli Edelman
• Jacob Martin Edge, DO
• Katrina Marie Edie, FNP-C

• Orthopedic Chiropractor in Neosho, MO
• Providers in Neosho, MO by specialty
• Orthopedic Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.