Greg Douglas, LISW-S, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

COA.17489-NP Issued in OH

Practice address

7341 S Timberlane Dr
Cincinnati, OH 45243-1843

Phone

(513) 793-3355

NPI assigned

Apr 8, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beckett Springs, LLC

  • Psychiatry Physician
  • West Chester, OH
  • NPI 1164856811
  NPD (past)

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1881867182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7341 S TIMBERLANE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452431843",
            "telephone_number": "513-793-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 S TIMBERLANE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452431843",
            "telephone_number": "513-793-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "GREG",
        "credential": "LISW-S, CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0700380-SUPV",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "COA.17489-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley A Doughty, M.D.
• Amy L Douglas
• Barbara Ann Douglas, RN
• Brian Matthew Douglas, MD
• Chanette Tierra Douglas
• Jasmine Douglas
• Latrice Douglas, MSW, LSW,CCM
• Lorna Douglas, LPC
• Marshea Lashone Douglas
• Sarah Douglas

• Psychiatric/Mental Health Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.