Individual provider Active NPI

Douglas Dothager, MD

  • Pulmonary Disease Physician
  • Belleville, IL
National Provider Identifier
1871599738
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036091795 Issued in IL
Practice address
4600 Memorial Dr Ste 200
Belleville, IL 62226-5363
Phone
(618) 233-2220
Fax
(618) 233-2555
NPI assigned
Jun 24, 2005
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036091795 IL Primary

Addresses

Primary practice location

4600 Memorial Dr Ste 200
Belleville, IL 62226-5363

Mailing address

4600 Memorial Dr
Ste. 120
Belleville, IL 62226-5368
Phone (618) 233-2220

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050920000931 IL Practitioner - Pulmonary Disease 2769441153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Vanderbilt University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

4600 Memorial Dr
Belleville, IL 62226-5363

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Dec 24, 2017 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Dec 24, 2017 Accepting new patients
Healthcare Physicians of Southern Illinois, PC Pulmonary Disease Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients
Southern Illinois Pulmonary Consultants, LTD. Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

4600 Memorial Dr
Ste 120
Belleville, IL 62226
Phone (618) 233-2220

4600 Memorial Dr
Ste 200
Belleville, IL 62226
Phone (618) 233-2220

4600 Memorial Dr
Ste 40
Belleville, IL 62226
Phone (618) 222-0000

1418 Cross St
Ste 350
Shiloh, IL 62269
Phone (618) 607-3900

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

Interoperability endpoints

  • Direct secure messaging: ddothager170911@direct.carenet.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1871599738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR",
            "address_2": "STE. 120",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265368",
            "telephone_number": "618-233-2220",
            "fax_number": "618-233-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265363",
            "telephone_number": "618-233-2220",
            "fax_number": "618-233-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTHAGER",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036091795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4600 Memorial Dr Ste 200",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.