NPIMap

Individual provider Active NPI

William M Dougherty, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Norfolk, VA
National Provider Identifier
1174968440
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
0101267145 Issued in VA
Practice address
600 Gresham Dr Ste 1100
Norfolk, VA 23507-1904
Phone
(757) 388-6200
Fax
(757) 388-6201
NPI assigned
May 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 0101267145 VA Primary

Addresses

Primary practice location

600 Gresham Dr Ste 1100
Norfolk, VA 23507-1904

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 388-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180524000407 OR Practitioner - Otolaryngology 3870720550 Reassigns benefits to 1 organization
I20190806003990 VA Practitioner - Otolaryngology 3870720550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 668-3483

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision49
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evms Academic Physicians and Surgeons Health Services Foundation CurrentSince Aug 1, 2019 Accepting new patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Ste 5
Portland, OR 97239
Phone (503) 494-6687

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

500 Discovery Dr
Chesapeake, VA 23320
Phone (757) 668-2311

11783 Rock Landing Dr
Newport News, VA 23606
Phone (757) 668-6550

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

6261 E Virginia Beach Blvd
Ste 200
Norfolk, VA 23502
Phone (757) 625-4455

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

600 Gresham Dr
Ste 1100
Norfolk, VA 23507
Phone (757) 388-6200

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

2075 Glenn Mitchell Dr
Ste 310
Virginia Beach, VA 23456
Phone (757) 689-8500

2021 Concert Dr
Virginia Beach, VA 23456
Phone (757) 668-6550

Organizations & group practices 4

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1174968440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-388-6200",
            "fax_number": "757-388-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 1100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-6200",
            "fax_number": "757-388-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "VA",
            "license": "0101267145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.