William L Dougherty, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002982 Issued in GA

Practice address

615 S Hansell St
Thomasville, GA 31792-5556

Phone

(229) 226-2234

Fax

(229) 226-2237

NPI assigned

Aug 29, 2006

Last updated

Aug 26, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.dougherty.1@15318.direct.athenahealth.com

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.

• Southern Interventional Pain Center LLC

  • Interventional Pain Medicine Physician
  • Thomasville, GA
  • NPI 1306225479
  Medicare reassignment
• Southern Interventional Pain Center LLC

  • Interventional Pain Medicine Physician
  • Tallahassee, FL
  • NPI 1407315948
  NPD
• Marion O. Lee,Jr. M.D., P.C.

  • Interventional Pain Medicine Physician
  • Cordele, GA
  • NPI 1790013613
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1063520880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S HANSELL ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925556",
            "telephone_number": "229-226-2234",
            "fax_number": "229-226-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S HANSELL ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925556",
            "telephone_number": "229-226-2234",
            "fax_number": "229-226-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doctors Anesthesia
• Gregory E Dodson, PAC
• Camille Domingo, MD
• Eric Laroy Donald
• Robert Michael Donovan, P.A.
• Valarie Michelle Dozier, D.D.S.
• James Darin Drury, M.D.
• Philip James Dubose Jr., PSY.D.
• Rachel Marie Duggar
• Marshall C Dunaway

• Physician Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.