Michael L Douglas, D.O.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

TN0000003191 Issued in TN

Practice address

200 New York Ave Ste 250
Oak Ridge, TN 37830-5227

Phone

(865) 835-5880

Fax

(865) 374-2009

NPI assigned

Jun 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Urology

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
• Roane Medical Center Hospital, Harriman, TN, CCN 440031
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mdouglas@tua1320.srs-direct.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Urology

  Medicare reassignment Care Compare group NPD
• Blount Memorial Physician Group, Inc

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1699710194

  Urology

  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD

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

• Cumberland Medical Center, Inc.

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403
  Care Compare affiliation
• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation
• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation
• Roane County Medical Center

  • General Acute Care Hospital
  • Harriman, TN
  • NPI 1700036696
  Care Compare affiliation

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1902169543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 250",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5880",
            "fax_number": "865-374-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 250",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5880",
            "fax_number": "865-374-2009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Oak Ridge Tpke Ste A101",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306927",
            "country_code": "US",
            "telephone_number": "865-483-1093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Bmh Physicians Office Bldg",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "37804",
            "country_code": "US",
            "telephone_number": "865-980-5260",
            "fax_number": "865-980-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "TN0000003191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q030847",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "douglas.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "200 New York Ave Ste 250",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378305227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Urology Physician in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.