Derek Bradley Douglas, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2021020693 Issued in MO

Practice address

4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098

Phone

(573) 596-0035

NPI assigned

Feb 26, 2018

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Hospital Carthage

  • Critical Access Hospital
  • Carthage, MO
  • NPI 1003201955

  Emergency Medicine

  Medicare reassignment NPD
• Mercy Hospital Springfield

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1043242159
  Medicare reassignment NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Medicare reassignment NPD
• Texas County Memorial Hospital

  • General Acute Care Hospital
  • Houston, MO
  • NPI 1790740363

  Emergency Medicine

  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Mountain View, MO
  • NPI 1003946732
  NPD
• Mercy Hospital Carthage

  • Family Medicine Physician
  • Carthage, MO
  • NPI 1558628222
  NPD
• Mercy Hospital Springfield

  • Medicare Defined Swing Bed Hospital Unit
  • Springfield, MO
  • NPI 1053907113
  NPD
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD
• Texas County Memorial Hospital

  • Clinic/Center
  • Houston, MO
  • NPI 1497593719
  NPD

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1902307762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 ILLINOIS AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 ILLINOIS AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DEREK",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2021020693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dolan, RDN
• Justin Marshall Dominguez, DPT
• Maria Mercedes Dominguez, PHD, LMFT
• Crystal Le-Ann Dornbach-Poojari, PHARM. D.
• Candice Renee Douglas, FNP-C
• Patrick Lee Downing Jr., RDN
• Zaine Robert Dugan
• Stephen Lindsey Dunaway, LCSW
• Braxton Stanley Duncan, DDS
• Debra A Duncan, MSW

• Emergency Medicine Physician in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.