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DR. KELLY MARIE DOUGLAS M.D. NPI 1366889909


NPI Information

NPI: 1366889909
Provider Name: DR. KELLY MARIE DOUGLAS, M.D.
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1125 MADISON ST
JEFFERSON CITY, MO
ZIP 65101
Phone: (573) 632-5000
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DR. Kelly Marie Douglas, M.D. is an emergency medicine in Jefferson City, MO with 11 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Kelly Marie Douglas, M.D. NPI is 1366889909. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

1125 MADISON ST
JEFFERSON CITY, MO
ZIP 65101-227
Phone: (573) 632-5000

The NPI 1366889909 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/22/2013 and was last updated on 9/14/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency Medicine2014014696MISSOURINo
2207P00000XEmergency MedicineMD-44341IOWANo
3207R00000XInternal MedicineR-9673IOWANo
4207R00000XInternal Medicine2021016294MISSOURINo
5207P00000XEmergency Medicine2021016294MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.