Paul S Daugherty, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD11629 Issued in TN

Practice address

107 Imperial Blvd
Suite 5
Hendersonville, TN 37075

Phone

(615) 826-3111

Fax

(615) 826-3112

NPI assigned

Dec 18, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144383738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1734",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370771734",
            "telephone_number": "615-826-3111",
            "fax_number": "615-826-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 IMPERIAL BLVD",
            "address_2": "SUITE 5",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-826-3111",
            "fax_number": "615-826-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD11629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "4004046",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1067920",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loucinda Rochelle Dampier, M.D.
• Daniel C. Burchfield, DMD Et Al PTR.
• Rebekah Daniels
• Scott Wade Darks, M.A.
• Lindsey Dartt
• Britne Daughtdrill, LPC
• Jennifer Daughtry
• Pascal A. Dauphin, M.D.
• Julie Davenport
• Mary Angela Davenport, L.M.F.T.

• Internal Medicine Physician in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.