NPIMap

Organization Active NPI

Doug S Clouse MD PLC

Doing business as Orthopedic and Sports Performance Institute

  • Specialist
  • Kingman, AZ
National Provider Identifier
1902420698
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DOUG S CLOUSE MD PLC
Doing business as
Orthopedic and Sports Performance Institute
Practice address
3636 N Stockton Hill Rd Ste 3
Kingman, AZ 86409-0514
Phone
(480) 899-4333
Fax
(480) 899-7219
NPI assigned
May 29, 2020
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Doug Steven Clouse, MDNPI 1285781401
Title
MD/Owner
Phone
(480) 899-4333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

3636 N Stockton Hill Rd Ste 3
Kingman, AZ 86409-0514

Mailing address

2450 S Gilbert Rd Ste 109
Chandler, AZ 85286-1594
Phone (480) 899-4333

Other names 1

  • Orthopedic and Sports Performance Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doug S Clouse MD PLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3636 N Stockton Hill Rd
Ste 3
Kingman, AZ 86409

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1902420698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 S GILBERT RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861594",
            "telephone_number": "480-899-4333",
            "fax_number": "480-899-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N STOCKTON HILL RD STE 3",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090514",
            "telephone_number": "480-899-4333",
            "fax_number": "480-899-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUG S CLOUSE MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "CLOUSE",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "480-899-4333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic and Sports Performance Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthopedic and Sports Performance Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.