Colleen M Dougherty Bullen, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3785 Issued in TN

Practice address

8904 Cross Park Dr
Knoxville, TN 37923-4703

Phone

(865) 690-2671

Fax

(865) 690-6445

NPI assigned

Mar 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Colleen Marie Dougherty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1285804492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-8930",
            "fax_number": "423-285-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 CROSS PARK DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234703",
            "telephone_number": "865-690-2671",
            "fax_number": "865-690-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY BULLEN",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "DOUGHERTY",
            "middle_name": "MARIE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Brett Doty
• Laura P Doty, ARPN
• Thomas W Doty, MD
• Tina Elaine Doty, NP
• Paul Michael Doucet, DO
• Leanne Ingle Dougherty, LCSW DSW
• Phillip James Dougherty, DO
• Allison Cooke Douglas, MS
• Donald R Douglas, PA
• Elizabeth Marcie Douglas, LPN

• Occupational Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.