Active NPI
Jacqueline Rochelle Douge, MD
- Pediatrics Physician
- Columbia, MD
National Provider Identifier
1942218300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0062894
- Practice address
- 8930 Stanford Blvd
Columbia, MD 21045-5805 - Phone
- (410) 313-7569
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0062894 | MD | Primary |
| Pediatrics Physician | 208000000X | 25MA06824100 | NJ |
Addresses
Primary practice location
8930 Stanford Blvd
Columbia, MD 21045-5805
Mailing address
8930 Stanford Blvd
Columbia, MD 21045-5805
Phone (410) 313-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040747SKZ | Other | NJ | PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0062894 | MD | MD | Pediatrics Physician |
| 25MA06824100 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shore Health Group, PC | Pediatrics | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404691200000",
"number": "1942218300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8930 STANFORD BLVD",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210455805",
"telephone_number": "410-313-7569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8930 STANFORD BLVD",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210455805",
"telephone_number": "410-313-7569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGE",
"first_name": "JACQUELINE",
"middle_name": "ROCHELLE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2014-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0062894",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA06824100",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN",
"identifier": "040747SKZ",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.