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

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: November 08, 2026.

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

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 maintains 2 additional practice locations.

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
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11515 Union AveMoberly, MO 65270-9407 · Phone (660) 263-8400
Location 21 Hospital DrColumbia, MO 65212-0001 · Phone (573) 882-8091 · Fax (573) 884-1902

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kelly Douglas reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Curators Of The University Of Missouri
27 mi
Multi-Specialty
1 HOSPITAL DR
Columbia, MO 65212
  • Reassigned Medicare billing, Missouri enrollment
  • 1,395 clinicians in this Medicare group
NPI 1235126921 (573) 882-4141
Ripley Emergency Group, LLC
114 mi
Emergency Medicine
315 S OSTEOPATHY AVE
Kirksville, MO 63501
  • Reassigned Medicare billing, Missouri enrollment
  • 78 clinicians in this Medicare group
NPI 1720606023 (660) 785-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Interoperability100
Improvement Activities40

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.

MRS. HEATHER DAWN BARNES OTR
Occupational Therapist
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5651
CAPITAL REGION MEDICAL CENTER
Durable Medical Equipment & Medical Supplies
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5750
DR. DANIEL HULSE DO
Student in an Organized Health Care Education/Training Program
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 623-5301
MRS. LANA ELAINE WANSTREET CRNA
Nurse Anesthetist, Certified Registered
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5000
SUSAN STACKELHOUSE VOSS
Pediatrics
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5525
CAPITAL REGION MEDICAL CENTER
Psychiatry & Neurology (Neurology)
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5666
BART S BOWERS CRNA
Nurse Anesthetist, Certified Registered
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5000
DR. HEMAL YOGESH PATEL MD
Hospitalist
1125 MADISON ST
JEFFERSON CITY, MO 65101
Cole County (573) 632-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Kelly Douglas located?

Kelly Douglas practices at 1125 Madison St, Jefferson City, MO 65101. The listed phone number is (573) 632-5000.

What is Kelly Douglas's specialty?

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

Is Kelly Douglas enrolled in Medicare?

Yes. Kelly Douglas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Douglas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Douglas reassigns Medicare benefits to 2 organizations: The Curators Of The University Of Missouri (Columbia, MO) and Ripley Emergency Group, LLC (Kirksville, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Douglas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Douglas accept?

Health plans from Anthem Blue Cross and Blue Shield and Medica list Kelly Douglas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Douglas affiliated with any hospitals?

According to CMS data, Kelly Douglas is affiliated with Moberly Regional Medical Center and University Of Missouri Health Care.

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 4 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.