Walter James Douglass, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

7751 Issued in SC

Practice address

853 N Church St
Suite 620
Spartanburg, SC 29303-3098

Phone

(864) 560-1674

Fax

(864) 560-1690

NPI assigned

Jan 30, 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 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: wdouglass37072@direct-srhs.et0939.epichosted.com

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1962473777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST",
            "address_2": "SUITE 620",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033098",
            "telephone_number": "864-560-1674",
            "fax_number": "864-560-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "WALTER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "7751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077561",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4226842",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890545G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "23151",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wdouglass37072@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wdouglass37072@direct-srhs.et0939.epichosted.com",
            "address_1": "853 N Church St",
            "address_2": "SUITE 620",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittney Doornbos, DO
• Aaron Dorsett
• Jasmine Dorsett
• Courtney Alanna Dorsey, FNP-BC
• Kevin Michael Douglass, M.D.
• Shannon Weber Doutt, MD/PHD
• Wesley Dove, M.ED.
• Shanelle Dowdell
• David A Dowe, MD
• Kyran Dowling, MD

• Gastroenterology Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Gastroenterology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.