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Deactivated NPI 1811942485 Deactivated / Inactive NPI Male Practitioner

Dr. Dane Edward Douglas , MD

Specialist • Memphis, TN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Dane Douglas has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 23, 2006
NPI Deactivation Date January 29, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Dane Douglas, MD was a registered Specialist practicing in Memphis, TN. Throughout an active medical career spanning 13 years, Dr. Douglas provided care at the practice location at 6401 POPLAR AVE until profile deactivation on 2019-01-29.

Practice Location & Contact Primary Location

Practice Address

6401 Poplar Ave
# 402

Memphis, TN 381194823

Telephone 9016242788
Fax 9016242997
Associated Practice Facility / Clinic
🏢 Pennmarc Internal Medicine Pc Facility NPI 1952363632

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Memphis, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 38.1 Yrs
State Avg: 36.3 Yrs
Regional Practice Density
98 Specialists

Practicing in Memphis, TN (784 Statewide)

Telehealth Adoption Rate
2.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License TN 21716

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
NPI 1013084953

Doctor of Medicine (M.D.)

Dr. Patricia Eby , MD

Plastic Surgery

NPI 1063456176

Doctor of Medicine (M.D.)

NPI 1083719785

Doctor of Medicine (M.D.)

NPI 1134139199

Doctor of Medicine (M.D.)

Dr. William Weiss , MD

Internal Medicine

NPI 1386713808

Doctor of Medicine (M.D.)

Dr. Paul Katz , MD

Internal Medicine

NPI 1497753131

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 29, 2019

Record deactivated on January 29, 2019

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 6401 POPLAR AVE, # 402, MEMPHIS, TN 381194823 (Tel: 9016242788)

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Updated Business Mailing Address July 09, 2007

Registered at 2985 CANNING CV, MEMPHIS, TN 381198745 (Tel: 9013090880)

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Provider Name / Credentials Updated July 09, 2007

Recorded as DANE DOUGLAS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Specialist (License #21716 in TN)

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Initial NPI Registration & Enumeration May 23, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811942485
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 23, 2006
Last Update: July 09, 2007
Deactivation Date: January 29, 2019

Mailing Address

2985 Canning Cv

Memphis, TN 381198745

Phone: 9013090880

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.