ROBERT JAMES DOUGLAS (NPI# 1053574137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053574137 |
| Entity Type | Individual |
| Full Name | ROBERT JAMES DOUGLAS |
| Credential | MD |
| Practice Address |
13865 Locust Ln Nampa ID 83686-9367 |
| Mailing Address |
2510 Inagua Ave N/a Coconut Grove FL 33133-3812 |
| Practice Telephone | 2089894991 |
| Mailing Telephone | 2089894991 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME13225 | FL | Other Service Providers |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME13225 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DEA | FDO684109 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194108225 | Robert Douglas Jr. | Contractor | 65 Grand Valley Ct, Howard, OH 43028-9200 | 2015-07-07 |
| 1730436593 | Robert T Douglas | Pharmacist | 335 Se Valley View Way, Chehalis, WA 98532-4304 | 2012-08-11 |
| 1710243167 | Robert Gordon Douglas Jr. | Internal Medicine | 265 Old Black Point Rd, Niantic, CT 06357-3732 | 2012-04-10 |
| 1003938663 | Robert Duane Douglas | Dentist | 160 S Bellwood Dr Ste B, East Alton, IL 62024-2086 | 2007-04-04 |
| 1861516239 | Robert Dean Douglas | Optometrist | 12412 Stafford St, Ravenna, MI 48451-0307 | 2007-03-19 |
| 1538182399 | Robert M Douglas | Radiology | 400 South 43rd Street, C/o Valley Radiation Oncology, Renton, WA 98055 | 2006-07-25 |
| 1790757417 | Robert N Douglas | Dentist | 424 Route 304, Bardonia, NY 10954-1613 | 2006-02-06 |
| 1104442508 | Robert Derrick Douglas | Specialist/Technologist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2020-06-22 |
| 1275856510 | Robert Leslie Douglas | Counselor | 10 Fiske Pl, Suite 228, Mount Vernon, NY 10550-3205 | 2010-03-01 |
| 1366532236 | Robert M Douglas | Family Medicine | 5555 E Arapahoe Rd, Centennial, CO 80122-2312 | 2006-10-13 |
| Street Address |
13865 LOCUST LN |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-9367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235260845 | Donald G Rau | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2007-03-07 |
| 1083751366 | Jeffrey Wayne Grossman | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2007-01-30 |
| 1649335373 | Idaho Advanced Imaging Pa | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2006-12-22 |
| 1538191200 | John H Truksa | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518597285 | Katie Clegg | Radiology | 593 W 24th St, Burley, ID 83318-2803 | 2020-01-22 |
| 1376920553 | Creighton Lewis | Radiology | 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 | 2015-04-27 |
| 1598176448 | Derek A Khorsand | Radiology | Kootenai Health, 2003 Kootenai Way, Coeur D'alene, ID 83814 | 2014-05-14 |
| 1578903191 | Miriam Bryna Hulkower | Radiology | 1839 N Govt Way Ste B, Coeur D Alene, ID 83814-3454 | 2013-06-27 |
| 1750647913 | Philip John Dougherty | Radiology | 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 | 2012-04-02 |
| 1356510143 | Newell Kay Richardson | Radiology | 2088 E 49th South, Idaho Falls, ID 83404-7649 | 2008-02-26 |
| 1477733574 | Cameron J Evans | Radiology | 4121 N 2600 E, Filer, ID 83328-5155 | 2007-11-06 |
| 1295926061 | Michael Modica | Radiology | 877 W Main St, Suite 603, Boise, ID 83702-5883 | 2007-08-07 |
| 1972709590 | Stephen Arthur Sherman | Radiology | 4685 Flora Dr, Pocatello, ID 83204-4568 | 2007-06-21 |
| 1891999165 | Vidvuds Bandrevics | Radiology | 102 Canyon Rd, Hailey, ID 83333-5067 | 2007-06-12 |
| Find all providers with the same taxonomy | ||||
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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.