Individual provider Active NPI

Jamie Michelle Dougherty, CAA

  • Anesthesiologist Assistant
  • Greenville, NC
National Provider Identifier
1285356147
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2000-00011 Issued in NC
Practice address
2430 Emerald PL Ste 201
Greenville, NC 27834-5743
Phone
(252) 752-2140
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2000-00011 NC Primary

Addresses

Primary practice location

2430 Emerald PL Ste 201
Greenville, NC 27834-5743

Mailing address

2430 Emerald PL Ste 201
Greenville, NC 27834-5743
Phone (252) 752-2140

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221101002536 NC Practitioner - Anesthesiology Assistant 9335516582 Reassigns benefits to 1 organization
I20251015002685 GA Practitioner - Anesthesiology Assistant 9335516582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of AthensGroup PAC ID 2567459902, 55 clinicians
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 543-3449

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

651 S Milledge Ave
Athens, GA 30605-1250
Phone (706) 543-3449

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
2000-00011NCMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC CurrentSince Oct 15, 2022 Accepting new patients
Anesthesia Consultants of Athens CurrentSince Oct 15, 2025 Accepting new patients

Locations

1500 Oglethorpe Ave
Ste 2100
Athens, GA 30606
Phone (706) 425-5437

651 S Milledge Ave
Athens, GA 30605
Phone (706) 546-9290

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2430 Emerald Pl
Ste 201
Greenville, NC 27834
Phone (252) 752-2140

Organizations & group practices 2

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 3

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1285356147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL STE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345743",
            "telephone_number": "252-752-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 EMERALD PL STE 201",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345743",
            "telephone_number": "252-752-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-847-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NC",
            "license": "2000-00011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.