Lisa L Daugherty, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7755 Issued in KY

Practice address

207A Alpine Dr
Shelbyville, KY 40065-8881

Phone

(502) 633-3900

Fax

(502) 633-3999

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeremy L Fairbourn DDS, PLLC

  • General Practice Dentistry
  • Shelbyville, KY
  • NPI 1396081576
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1083625347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207A ALPINE DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658881",
            "telephone_number": "502-633-3900",
            "fax_number": "502-633-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207A ALPINE DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658881",
            "telephone_number": "502-633-3900",
            "fax_number": "502-633-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "LISA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cumberland Family Medical Center Inc
• Mary Cupp, LCADC,CADC
• D & D Freedom PSC
• Darrin J. Violi, DMD, PSC
• Amanda B Dassel, PHARMD
• Dakota Davis
• Laura Elizabeth Davis, PA-C
• Lorinda Davis
• Matthew Davis
• Patrick A Davis

• General Practice Dentistry in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.