DR. KELLY MARIE DOUGLAS M.D.
NPI 1366889909
Emergency Medicine in Jefferson City, MO

Q: What is Kelly Douglas's NPI number?

The NPI number for Kelly Douglas is 1366889909. It was assigned to this individual provider in the NPPES registry on May 22, 2013.

Q: What is Kelly Douglas's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Douglas was last updated on September 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 22, 2013PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1125 MADISON ST, JEFFERSON CITY, MO 65101(573) 632-5000 Get Directions Write a Review

NPPES record last updated: September 14, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 14, 2022, Sep 30, 2021, Jul 19, 2021 and 4 more (7 updates tracked since 2017).

On this page

About Dr. Kelly Marie Douglas M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY MARIE DOUGLAS M.D. (NPI 1366889909) is an individual emergency medicine provider in Jefferson City, Missouri, licensed in Missouri (2021016294) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, is affiliated with Moberly Regional Medical Center, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2013).

NPPES Registry Identity

NPI1366889909

Entity TypeIndividualFemale

Primary Taxonomy207P00000X

Provider Legal NameDR. KELLY MARIE DOUGLASCredential: M.D.

Location Address1125 MADISON STJefferson City, MO 65101-5227

Mailing AddressPo Box 843966Kansas City, MO 64184-3966 · (573) 884-3300 · Fax (573) 884-0943

Phone(573) 632-5000

Sole ProprietorNo

Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2013

Enumeration DateMay 22, 2013

Last NPPES UpdateSeptember 14, 20227 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2021

✔ NPI 1366889909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in MO · 2021016294✔ Licensed in MO · 2014014696✔ Licensed in IA · MD-44341

Definition

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License R-9673 (IA), 2021016294 (MO)

1125 MADISON ST, Jefferson City, MO 65101

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly Marie Douglas M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365686359

PECOS Enrollment IDI20210723001652

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

157 services154 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

98 services96 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

83 services80 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

37 services37 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Moberly Regional Medical Center

Acute Care Hospitals · Moberly, MO

3/5 CMS rating

OwnershipProprietary

CMS Certification Number260074

Location1515 Union AveMoberly, MO 65270 · Randolph County

Emergency services

University Of Missouri Health Care

Acute Care Hospitals · Columbia, MO

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number260141

LocationOne Hospital DriveColumbia, MO 65212 · Boone County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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