CLAIRE DOUGLAS
NPI 1326369331
Hospitalist in Fayetteville, GA
NPI Status: Active since June 14, 2010
Contact Information
1255 HIGHWAY 54 W
FAYETTEVILLE, GA
ZIP 30214
Phone: (404) 367-3014
- Individual
- Female
- Hospitalist
- Accepts Insurance
- PECOS Enrolled
About CLAIRE DOUGLAS
This page provides the complete NPI Profile along with additional information for Claire Douglas, a provider established in Fayetteville, Georgia with a medical specialization in Hospitalist. The healthcare provider is registered in the NPI registry with number 1326369331 assigned on June 2010. The practitioner's primary taxonomy code is 208M00000X with license number 069575 (GA). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1326369331
- Provider Name
- CLAIRE DOUGLAS
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214
- Location Phone
- (404) 367-3014
- Mailing Address
- 35 COLLIER RD NW STE 635 ATLANTA, GA 30309
- Mailing Phone
- (404) 367-3014
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-14-2010
- Last Update Date
- 05-08-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Hospitalist
- Taxonomy Code
- 208M00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 069575
- License State
- GA
- Taxonomy Description
- Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Claire Douglas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days
This service involves gathering and analyzing health data from a patient, which is digitally stored and sent to a healthcare professional. This may include heart rate, blood pressure, or blood sugar levels. The process takes at least 30 minutes and is repeated every 30 days.
This service was performed 128 times for 74 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 30214 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.64
- Minimum New Patient Price $56.84
- Maximum New Patient Price $172.43
- Average New Patient Copayment $32.66
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.1
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.2
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $140.4
- Average Established Patient Copayment $25.05
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $35.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 3 | 2 | 6 | 3 | 6 | 9 | 3 | 3 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 4 | 6 | 6 | 6 | 18 | 3 | 6 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 4 + 6 + 6 + 6 + 1 + 8 + 3 + 6 + 24 = 69 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 69 = 1 | 1 |
The NPI number 1326369331 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1376641142 | MS. DENISE LOUISE BENNETT MS, RD, LD, CDE Individual | Dietitian, Registered | 1255 HIGHWAY 54 W PIEDMONT FAYETTE HOSPITAL - DIABETES EDUCATION DEPT FAYETTEVILLE, GA 30214 (770) 719-6621 |
1871649889 | DIANA RANNA NP Individual | Nurse Practitioner | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7295 |
1336269950 | MRS. SUSAN STOOKSBURY BAKER PT, MS Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7183 |
1679693295 | MRS. AMY WILLIAMSON PT Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7183 |
1417077116 | BEVERLY BLAKELY PT Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7182 |
1962522649 | MS. KATHRYN LEE HARRIS M.S.CCC-SLP Individual | Speech-Language Pathologist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7185 |
1003936790 | MRS. LISA LAJUNE SMITH PT, M.ED. Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7183 |
1467572941 | MS. MIRANDA M BLASER DPT Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7184 |
1366562712 | KAREN MICHELE VARISCO-RUSSELL PTA Individual | Physical Therapy Assistant | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7183 |
1982818894 | MS. MELISSA KAYE JOHNSON PT, CWS Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7196 |
1316151087 | KERI SUNVOLD Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7256 |
1649488776 | MRS. LARA BOOK WHITAKER P.T. Individual | Physical Therapist | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7180 |
1598968646 | JULIE HALL PARKER P.T.A. Individual | Physical Therapy Assistant | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7183 |
1760651665 | PIEDMONT FAYETTE HOSPITAL Organization | Chronic Disease Hospital | 1255 HIGHWAY 54 W HEART FAILURE CENTER FAYETTEVILLE, GA 30214 (770) 719-6747 |
1255586004 | PEDIATRIC EMERGENCY MEDICINE ASSOCIATES LLC Organization | Pediatrics (Pediatric Emergency Medicine) | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (678) 344-1960 |
1477782399 | MRS. MARIA MAGDALENA EARNHART Individual | Anesthesiologist Assistant | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7000 |
1548586761 | FAYETTE EMERGENCY GROUP LLC Organization | Emergency Medicine | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7000 |
1356653273 | PAUL JOSEPH OENICK PA Individual | Physician Assistant | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (800) 893-9698 |
1780998278 | KAREN GOODING ANP-C Individual | Nurse Practitioner | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-6059 |
1609176221 | GEORGE BENJAMIN THORNTON Individual | Anesthesiologist Assistant | 1255 HIGHWAY 54 W FAYETTEVILLE, GA 30214 (770) 719-7000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326369331, enumerated in the NPI registry as an "individual" on June 14, 2010
The provider is located at 1255 Highway 54 W Fayetteville, Ga 30214 and the phone number is (404) 367-3014
The provider's speciality is Hospitalist with taxonomy code 208M00000X
The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $130.64 with an average copayment of $32.66 for new patient appointments. Established patients should expect a typical charge of $100.2 and an average copayment of 25.05. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days.
This NPI record was last updated on June 14, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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