Frederick G Douglas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5691 Issued in SC

Practice address

106 John Street
Easley, SC 29640-1415

Phone

(864) 859-2220

Fax

(864) 859-5744

NPI assigned

Jun 12, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Baptist Easley Hospital

  • Orthopaedic Surgery Physician
  • Easley, SC
  • NPI 1134350358
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1922040955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296412089",
            "telephone_number": "864-855-5104",
            "fax_number": "864-859-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 JOHN STREET",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296401415",
            "telephone_number": "864-859-2220",
            "fax_number": "864-859-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "FREDERICK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "5691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "582296052055",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134768",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056913",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Jo Dodgens, O.D.
• Kimberly Brooke Donald, APRN, FNP-C
• Meghan Jeanne Dopart, PHARMD
• Dosher Physical Therapy Associates Inc
• Michael L Dosher, PT
• Dr Jack Chiropractor Inc
• Dr. John R. White, DDS & Dr. Chris N. Siachos, DMD
• DRN Medical LLC
• Dsi Greenville, LLC
• Dsi Renal Inc

• Family Medicine Physician in Easley, SC
• Providers in Easley, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.