Individual provider Active NPI

Renee D Doherty, MD

  • Pediatric Anesthesiology Physician
  • Falls Church, VA
National Provider Identifier
1336408103
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
R7983 Issued in TX
Practice address
3300 Gallows Rd
Department of Surgery
Falls Church, VA 22042-3307
Phone
(703) 706-2237
Fax
(703) 776-2338
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R7983 TX
Anesthesiology Physician 207L00000X 74769 WI
Pediatric Anesthesiology Physician 207LP3000X 2019041276 MO
General Practice Physician 208D00000X 0101257424 VA
Pediatric Anesthesiology Physician 207LP3000X R7983 TX Primary

Addresses

Primary practice location

3300 Gallows Rd
Department of Surgery
Falls Church, VA 22042-3307

Mailing address

3140 Harlequin LN
Saint Louis, MO 63139-1776
Phone (205) 349-9878

Other practice location 1

1000 N Oak Ave # 1000
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 2

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Other practice location 3

1 Childrens Pl Dept Of
Saint Louis, MO 63110-1002
Phone (800) 862-9980

Other names 1

  • Renee Dawn White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI, MO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150622001994 TX Practitioner - AnesthesiologyPractitioner - General Practice 1052622727 Reassigns benefits to 5 organizations
I20210121001271 WI Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 1052622727 Reassigns benefits to 2 organizations
I20230607002704 MO Practitioner - Anesthesiology 1052622727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 454-6000

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7983TXMDAnesthesiology Physician
74769WIMDAnesthesiology Physician
2019041276MOMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Jan 4, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients
MCHS Hospitals Inc Anesthesiology Current Accepting new patients
Cherokee Nation CurrentSince Jun 23, 2015 Accepting new patients
Cherokee Nation Current Accepting new patients
Texas Children'S Physician Group CurrentSince Aug 29, 2022 Accepting new patients
Anesthesia Alliance of Dallas, P.a. Anesthesiology CurrentSince Jan 23, 2024 Accepting new patients
Washington University CurrentSince Dec 16, 2024 Accepting new patients
Washington University CurrentSince Dec 16, 2024 Accepting new patients
Children'S Physician Services of South Texas CurrentSince Jan 1, 2024 Accepting new patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Apr 15, 2024 Accepting new patients
Children'S Physician Services of South Texas CurrentSince Jan 1, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Apr 15, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
Texas Anesthesia Partners, PLLC Anesthesiology Past Accepting new patients
Children'S Physician Services of South Texas Past Accepting new patients

Locations (25 of 54)

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

501 E 5th St
Bartlesville, OK 74003
Phone (918) 336-0823

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

700 Highlander Blvd
Ste 415
Arlington, TX 76015
Phone (817) 330-1102

4343 N Josey Ln
Carrollton, TX 75010
Phone (972) 394-2280

1401 E Trinity Mills Rd
Carrollton, TX 75006
Phone (972) 810-0700

731 Plaza Blvd
Coppell, TX 75019
Phone (469) 451-5700

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

3533 S Alameda St
Ste 203
Corpus Christi, TX 78411

2727 E Lemmon Ave
Dallas, TX 75204
Phone (214) 443-3000

11411 E Northwest Hwy
Ste 220
Dallas, TX 75218
Phone (469) 214-4344

11970 N Central Expy
Dallas, TX 75243
Phone (972) 566-7111

3920 Worth St
Dallas, TX 75246
Phone (214) 443-3000

9080 Harry Hines Blvd
Ste 110
Dallas, TX 75235
Phone (214) 631-7880

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

9 Medical Pkwy
Ste 207A
Dallas, TX 75234

8111 Meadow Rd
Dallas, TX 75231
Phone (214) 471-5975

7502 Greenville Ave
Dallas, TX 75231
Phone (469) 221-6000

Interoperability endpoints

  • Direct secure messaging: rdoherty914077@direct.carenet.org
  • Direct secure messaging: renee.doherty@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1336408103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 HARLEQUIN LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391776",
            "telephone_number": "205-349-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-706-2237",
            "fax_number": "703-776-2338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Oak Ave # 1000",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Pl Dept Of",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101002",
            "country_code": "US",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "RENEE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R7983",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "74769",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MO",
            "license": "2019041276",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101257424",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "R7983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "WHITE",
            "middle_name": "DAWN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.