Individual provider Active NPI

Emily S Doherty, M.D.

  • Pediatrics Physician
  • Roanoke, VA
National Provider Identifier
1134149495
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101239245 Issued in VA
Practice address
4348 Electric Rd
Roanoke, VA 24018-0720
Phone
(540) 769-0976
Fax
(540) 857-5390
NPI assigned
Jul 20, 2006
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 0101239245 VA
Pediatrics Physician 208000000X 0101239245 VA Primary

Addresses

Primary practice location

4348 Electric Rd
Roanoke, VA 24018-0720

Mailing address

102 Highland Ave SE
Suite 104
Roanoke, VA 24013-2256
Phone (540) 985-8147

Other identifiers 1

IdentifierTypeStateIssuer
010298423MedicaidVA

Other names 1

  • Emily A Saks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20060908000241 VA Practitioner - Medical Genetics and GenomicsPractitioner - Pediatric Medicine 0143224980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Pediatric Medicine
Education
University of Virginia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

4348 Electric Rd
Roanoke, VA 24018-0720
Phone (540) 769-0976

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239245VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Apr 12, 2010 Accepting new patients
Carilion Medical Center CurrentSince Apr 12, 2010 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

102 Highland Ave SE
Ste 104
Roanoke, VA 24013
Phone (540) 343-4423

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

902 S Jefferson St
Roanoke, VA 24016
Phone (540) 985-8230

Interoperability endpoints

  • Direct secure messaging: edoherty9724@direct.carilionclinic.org

Organizations & group practices 3

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 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1134149495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HIGHLAND AVE SE",
            "address_2": "SUITE 104",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132256",
            "telephone_number": "540-985-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180720",
            "telephone_number": "540-769-0976",
            "fax_number": "540-857-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "EMILY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "VA",
            "license": "0101239245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101239245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010298423",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "SAKS",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.