David Douglas, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

51755361206 Issued in UT

Practice address

5312 W Shaggy Peak Dr
Riverton, UT 84096-6418

Phone

(801) 792-3635

Fax

(801) 446-1305

NPI assigned

Feb 9, 2007

Last updated

Jan 27, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Alpine Health and Rehabilitation Center LC

  • Chiropractor
  • West Jordan, UT
  • NPI 1861419608
  NPD (past)
• Biorestoration Medical

  • Family Medicine Physician
  • Draper, UT
  • NPI 1902286297
  NPD (past)
• Salson Clinics LLC

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1083015275
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1932240207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 W SHAGGY PEAK DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840966418",
            "telephone_number": "801-792-3635",
            "fax_number": "801-446-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5312 W SHAGGY PEAK DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840966418",
            "telephone_number": "801-792-3635",
            "fax_number": "801-446-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DAVID",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "51755361206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "51755361206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Edward Devries, DMD
• Yessica Diaz
• Jessica DO, PA
• Eric Richard Dockter, M.D.
• Hannah Doty, CSW
• Brett W Doxey, MD
• Chelise Draper
• James W Drury, PT
• J Timothy Duffy, MD
• Robert Gene Duncombe, SSW, M.S.

• Medical Physician Assistant in Riverton, UT
• Providers in Riverton, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.