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DOUG FITZGERALD
NPI 1417130600
Counselor - Mental Health in Vicksburg, MS

Active since December 11, 2007PECOS EnrolledAccepts Medicare Assignment
3444 WISCONSIN AVE, VICKSBURG, MS 39180(601) 638-0031(601) 638-4950 Get Directions Write a Review

NPPES record last updated: December 11, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Doug Fitzgerald NPPES

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

DOUG FITZGERALD (NPI 1417130600) is an individual mental health provider in Vicksburg, Mississippi and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1417130600
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDOUG FITZGERALD
Location Address3444 WISCONSIN AVEVicksburg, MS 39180-5331
Mailing Address3444 Wisconsin AveVicksburg, MS 39180-5331 · (601) 638-0031 · Fax (601) 638-4950
Phone(601) 638-0031
Fax(601) 638-4950
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateDecember 11, 2007
✔ NPI 1417130600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3444 WISCONSIN AVE, Vicksburg, MS 39180
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.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

Doug Fitzgerald 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 ID8527591817
PECOS Enrollment IDI20241024003158
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 Reassignment

Medicare enrollment records show Doug Fitzgerald reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Positive Pathways, LLC
1.7 mi
Mental Health (Including Community Mental Health Center)
1905 MISSION 66
Vicksburg, MS 39180
  • Reassigned Medicare billing, Mississippi enrollment
  • 15 clinicians in this Medicare group
NPI 1801335492 (601) 813-5878

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

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.

TIFFANY SMITH
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
WARREN YAZOO MENTAL HEALTH SERVICE
Clinic/Center (Mental Health (Including Community Mental Health Center))
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
FELICIA WILSON PCMHT
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
HEATHER POTTS
Counselor (Addiction (Substance Use Disorder))
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
ROSALYN GLASCOE
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
ANN NELSON LSW
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
MILLICENT LEDBETTER
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031
MADALENE J BARKSDALE-MAYFIELD
Counselor (Mental Health)
3444 WISCONSIN AVE
VICKSBURG, MS 39180
Warren County (601) 638-0031

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 Doug Fitzgerald's NPI number?

The NPI number for Doug Fitzgerald is 1417130600. It was assigned to this individual provider in the NPPES registry on December 11, 2007.

Where is Doug Fitzgerald located?

Doug Fitzgerald practices at 3444 Wisconsin Ave, Vicksburg, MS 39180. The listed phone number is (601) 638-0031.

What is Doug Fitzgerald's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Doug Fitzgerald enrolled in Medicare?

Yes. Doug Fitzgerald 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 organization bills Medicare for Doug Fitzgerald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Doug Fitzgerald reassigns Medicare benefits to Positive Pathways, LLC (Vicksburg, MS). The 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 Doug Fitzgerald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Doug Fitzgerald accept?

Health plans from Cigna Healthcare list Doug Fitzgerald 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.

When was this NPI record last updated?

The NPPES record for Doug Fitzgerald was last updated on December 11, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.