Christopher P Dougherty, D.O.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

E476114 Issued in AR

Practice address

1504 SE 28TH St
Bentonville, AR 72712-3988

Phone

(479) 273-1111

Fax

(479) 273-1255

NPI assigned

Sep 7, 2005

Reactivated

Apr 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Orthopedic Surgery

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ozarks Community Hospital of Gravette Hospital, Gravette, AR, CCN 041331
• Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christopher.dougherty.1@9874.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/9874/brand/1/csg/1/fhir/r4

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.

• Arkansas Center for Arthroscopy, PA

  • Orthopaedic Surgery Physician
  • Bentonville, AR
  • NPI 1568529295
  Medicare reassignment NPD Authorized official
• Sgoh Acquisition Inc

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005

  Sports Medicine

  Medicare reassignment NPD
• F&S Physical Therapy, Inc.

  • Physical Therapist
  • Alma, AR
  • NPI 1518936418
  Care Compare group
• Sgoh Acquisition Inc

  • Rural Health Clinic/Center
  • Decatur, AR
  • NPI 1699513507
  NPD
• Arkansas Center for Arthroscopy

  • Specialist
  • Bentonville, AR
  • NPI 1275561516
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation
• Northwest Arkansas Hospitals, LLC

  • General Acute Care Hospital
  • Springdale, AR
  • NPI 1699726695
  Care Compare affiliation
• Sgoh Acquisition Inc

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Care Compare affiliation

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1124012000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SE 28TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123988",
            "telephone_number": "479-273-1111",
            "fax_number": "479-273-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 SE 28TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123988",
            "telephone_number": "479-273-1111",
            "fax_number": "479-273-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2009-10-08",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AR",
            "license": "E476114",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2003014160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161277002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206074312",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kynvieya Donnerson
• Haley Marie Donoway, RD
• Dorothy L Mellon MD PA
• Aaron P Doss
• Katherine Doss, M.S. CCC-SLP
• Douglas Rinehart, DDS, P.a.
• Kierstin M Douglas
• Megan Dover, PHARMD
• Alexis Downs, PA-C
• Lauren Doyel, MA

• Sports Medicine (Orthopaedic Surgery) Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.