Amy Alicia Dougherty, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP011230 Issued in PA

Practice address

800 Spruce
Philadelphia, PA 19107-5211

Phone

(215) 615-3020

NPI assigned

Jul 26, 2011

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 10

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ, WV, MA, NY5 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 5

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.dougherty@337577483108356.direct.elationemr.com

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.

• Mydoc Urgent Care

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1689067472
  Medicare reassignment NPD
• Central Jersey Urgent Care

  • Urgent Care Clinic/Center
  • Ocean, NJ
  • NPI 1316285091
  Medicare reassignment NPD
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661

  WV

  Medicare reassignment
• Central Jersey Urgent Care

  • Urgent Care Clinic/Center
  • Skillman, NJ
  • NPI 1407421985
  NPD
• Openloop Healthcare Partners California PC

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1598418063
  NPD
• Openloop Healthcare Partners California PC

  • General Practice Physician
  • Palm Desert, CA
  • NPI 1659042331
  NPD
• Openloop Healthcare Partners New Jersey PC

  • General Practice Physician
  • Jersey City, NJ
  • NPI 1588335152
  NPD

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1154609071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 S ALDER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191475620",
            "telephone_number": "215-313-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-615-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "AMY",
        "middle_name": "ALICIA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2022-06-28",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00912600",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0011673",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021191",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2361699",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R237822",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704371677",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349441-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "108881",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRNCNP0029439",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taline Doudaklian, RN
• Courtney Douds, LSW, MED
• Nasser Douge, MD
• Ailish Dougherty
• Amy Dougherty, D.P.M.
• Anne M Dougherty, AU.D.
• Caitlin J Dougherty, CRNP
• Caroline Nicole Dougherty, RN
• Catherine Rose Dougherty, PMHNP-BC
• David Dougherty, M.D.

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.