Individual provider Active NPI

Alexa Starr Dougherty, CNM

  • Advanced Practice Midwife
  • Boston, MA
National Provider Identifier
1124551668
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
850 Harrison Avenue
FL 4, Yawkey BLDG
Boston, MA 02118
Phone
(617) 414-2000
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 294219 NC
Registered Nurse 163W00000X CNM2300477 MA
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

850 Harrison Avenue
FL 4, Yawkey BLDG
Boston, MA 02118

Mailing address

801 Albany Street
FL G
Boston, MA 02119-3791

Other practice location 1

85 Herrick St
Beverly, MA 01915
Phone (978) 927-7880

Other practice location 2

226 Ashville Ave
Cary, NC 27518-6660
Phone (919) 852-1053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725001603 MA Practitioner - Certified Nurse Midwife (CNM) 2961759758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
CNM2300477MAMDRegistered Nurse
294219NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ocie Health and Midwifery, PLLC Advanced Practice Midwife Current Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Maternity Centers of America LLC Past Accepting new patients
Baby and Company Cary 1 LLC Past Accepting new patients

Locations

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
Fl 4
Boston, MA 02118
Phone (617) 414-2000

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: adougherty90819@direct.bmc.masshiway.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1124551668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVENUE",
            "address_2": "FL 4, YAWKEY BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Herrick St",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "01915",
            "country_code": "US",
            "telephone_number": "978-927-7880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "226 Ashville Ave",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275186660",
            "country_code": "US",
            "telephone_number": "919-852-1053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ALEXA",
        "middle_name": "STARR",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "294219",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "CNM2300477",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.