Active NPI
Monica Wilson Doherty, PHARM.D
- Pharmacist
- Ponchatoula, LA
National Provider Identifier
1003166513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18396
- Practice address
- 285 W Pine St
Ponchatoula, LA 70454-3310 - Phone
- (985) 386-6132
- NPI assigned
- Sep 12, 2012
- Last updated
- Dec 15, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18396 | LA | Primary |
| Pharmacist | 183500000X | 42739 | TX |
Addresses
Primary practice location
285 W Pine St
Ponchatoula, LA 70454-3310
Mailing address
PO Box 40363
Baton Rouge, LA 70835-0363
Phone (214) 223-3927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18396 | LA | MD | Pharmacist |
| 42739 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1003166513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40363",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708350363",
"telephone_number": "214-223-3927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 W PINE ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543310",
"telephone_number": "985-386-6132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "MONICA",
"middle_name": "WILSON",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "18396",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "42739",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.