Individual provider Active NPI

John Dougherty

  • Infectious Disease Physician
  • Valparaiso, IN
National Provider Identifier
1053722934
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01091630A Issued in IN
Practice address
56 Willow St
Valparaiso, IN 46383-4223
Phone
(219) 309-7254
NPI assigned
May 14, 2014
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01091630A IN Primary

Addresses

Primary practice location

56 Willow St
Valparaiso, IN 46383-4223

Mailing address

56 Willow St
Valparaiso, IN 46383-4223
Phone (219) 309-7254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GU2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170818000104 TX Practitioner - Internal Medicine 8123325297 Reassigns benefits to 1 organization
I20171222000381 GU Practitioner - Internal Medicine 8123325297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Northwestern University Feinberg Medical School, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

707 Cedar St
Suite 405
South Bend, IN 46617-2059

707 Cedar St
Suite 405
South Bend, IN 46617-2087

PO Box
Suite 781076
Detroit, MI 48278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Internal Medicine Current Accepting new patients
Guam Memorial Hospital CurrentSince Nov 13, 2017 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jul 10, 2017 Accepting new patients
Guam Memorial Hospital CurrentSince Nov 13, 2017 Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

3500 Franciscan Way
Ste 300
Michigan City, IN 46360
Phone (219) 214-4633

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

Interoperability endpoints

  • Direct secure messaging: jdougherty3129332@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1053722934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WILLOW ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834223",
            "telephone_number": "219-309-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WILLOW ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834223",
            "telephone_number": "219-309-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01091630A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.