SUMNER B DOUGLAS (NPI# 1548821333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548821333 |
Entity Type | Individual |
Full Name | SUMNER B DOUGLAS |
Credential | NP |
Practice Address |
401 Baptist Dr Ste 1040 Madison MS 39110-2009 |
Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
Practice Telephone | 6016052383 |
Practice Fax Number | 6016053898 |
Mailing Telephone | 9012261613 |
Mailing Fax Number | 9012278591 |
Enumeration Date | 2019-06-24 |
Last Update Date | 2020-09-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
903149 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1340 Broad Ave Ste 320, Gulfport, MS 395012464 | 2285751775 | 2285751770 |
Street Address |
401 BAPTIST DR STE 1040 |
City | MADISON |
State | MS |
Zip Code | 39110-2009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
Find all providers in zip 39110 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902424468 | Rachel Gallagher | Nurse Practitioner | 822 E Washington Ave, Madison, WI 53703-6500 | 2020-07-10 |
1932728177 | Cori Barkei | Nurse Practitioner | 3128 Limekiln St, Madison, WI 53719-2573 | 2020-04-08 |
1265075626 | Maria Rachuonyo | Nurse Practitioner | 165 Chestnut Dr, Madison, AL 35758-9524 | 2019-10-17 |
1942865365 | Marta Cooper | Nurse Practitioner | 579 Donofrio Dr Ste 1, Madison, WI 53719-2838 | 2019-05-02 |
1215490024 | Angela Wiggins | Nurse Practitioner | 1210 Briarville Rd Bldg B, Madison, TN 37115-5136 | 2019-04-09 |
1124585419 | Melissa Kay Albright | Nurse Practitioner | 44 Hughes Rd Ste 2500, Madison, AL 35758-3026 | 2019-02-22 |
1912475393 | Katlynn Ann Kelley | Nurse Practitioner | 20 S Park St Rm M417, Madison, WI 53715-1348 | 2018-11-05 |
1053887943 | Denita Ward | Nurse Practitioner | 2145 Fox Ave, Madison, WI 53711-1920 | 2018-10-17 |
1992203079 | Brandy J Smith | Nurse Practitioner | 703 Green Rd Ste 1, Madison, IN 47250-2145 | 2018-01-24 |
1447769468 | Cynthia Kline O'sullivan | Nurse Practitioner | 30 Highview Rd, Madison, CT 06443-2554 | 2017-09-21 |
Find all providers in MADISON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.