Preston S Douglas, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557713 Issued in VA

Practice address

101 Professional Park PVT Dr
Kingsport, TN 37663-2288

Phone

(423) 239-9122

Fax

(423) 239-7991

NPI assigned

Jan 7, 2021

Last updated

Jun 3, 2024By the provider in NPPES

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

Enrolled in VA, TN2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Life Chiropractic College, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elevate Sport and Spine, LLC

  dba Dr. Preston S. Douglas, DC

  • Chiropractor
  • Kingsport, TN
  • NPI 1932865409
  Medicare reassignment NPD Authorized official
• Muncy Spinal Institute LLC

  dba Muncy Family Chiropractic

  • Chiropractor
  • Bristol, VA
  • NPI 1144367046
  NPD (past)

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1922696780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632028",
            "telephone_number": "423-239-9122",
            "fax_number": "423-239-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK PVT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632288",
            "telephone_number": "423-239-9122",
            "fax_number": "423-239-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "PRESTON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-07",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557713",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "2000040788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Aaron Dorton
• Gretchen Leigh Doss, PHARMD
• Hope Nicole Dotson, DPT
• Tiffani M Dotson, MSN, PMHNP-BC
• Douglas Clayton Mullins II & Angel Kaye Mullins, DDS, PLLC
• Karissa Dowling, OTR/L
• Gregory Downey, CRNA
• Dr KC (Everstrong Physical Therapy and Wellness)
• Dr Mark Lynn & Associates PLLC (Visionworks Doctors of Optometry)
• Dr Susanne Toyne MD PLLC

• Chiropractor in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.