NPIMap

Individual provider Active NPI

Harry Karrick Daugherty Jr., MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Brentwood, TN
National Provider Identifier
1063473833
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101243107 Issued in VA
Practice address
5301 Virginia Way
Suite 300
Brentwood, TN 37027-7541
Phone
(615) 221-4474
Fax
(615) 234-3774
NPI assigned
Mar 31, 2006
Last updated
Apr 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 0101243107 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101243107 VA Primary

Addresses

Primary practice location

5301 Virginia Way
Suite 300
Brentwood, TN 37027-7541

Mailing address

5301 Virginia Way
Suite 300
Brentwood, TN 37027-7541
Phone (615) 221-4474

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidVA
PENDINGOtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000523 VA Practitioner - Pathology 9234169772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Saint Louis University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Pathology Solutions LLCGroup PAC ID 2668703109, 25 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 777-1430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243107VAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Pathology Solutions LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2021 Accepting new patients
Associated Pathologists LLC Past Accepting new patients

Locations

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

1 Arh Ln
Low Moor, VA 24457
Phone (540) 345-2593

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

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.

Hospital & facility affiliations 7

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1063473833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277541",
            "telephone_number": "615-221-4474",
            "fax_number": "615-234-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277541",
            "telephone_number": "615-221-4474",
            "fax_number": "615-234-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "HARRY",
        "middle_name": "KARRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "VA",
            "license": "0101243107",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101243107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.