Individual provider Active NPI

Thomas W Daugherty, MD

  • Orthopaedic Surgery Physician
  • Winchester, VA
National Provider Identifier
1366403461
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101020542 Issued in VA
Practice address
190 Campus Blvd Ste 310
Winchester, VA 22601-2872
Phone
(540) 667-9252
Fax
(540) 722-4514
NPI assigned
Mar 29, 2006
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101020542 VA Primary

Addresses

Primary practice location

190 Campus Blvd Ste 310
Winchester, VA 22601-2872

Mailing address

190 Campus Blvd Ste 310
Winchester, VA 22601-2872
Phone (540) 667-9252

Other identifiers 2

IdentifierTypeStateIssuer
P00208815OtherRAILROAD MEDICARE
0097779000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121025000532 WV Practitioner - Orthopedic Surgery 6608813571 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hampshire Memorial Hospital, Inc. CurrentSince Oct 1, 2012 Accepting new patients
War Memorial Hospital, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Hampshire Memorial Hospital Inc. CurrentSince Oct 1, 2012 Accepting new patients
War Memorial Hospital Inc CurrentSince Oct 1, 2012 Accepting new patients
Hampshire Memorial Hospital, Inc. Current Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Norton Community Physician Services LLC Orthopaedic Surgery Past Accepting new patients

Locations

190 Campus Blvd
Ste 310
Winchester, VA 22601
Phone (540) 536-0130

220 Campus Blvd
Ste 200
Winchester, VA 22601
Phone (540) 536-0307

1 Healthy Way
Berkeley Springs, WV 25411
Phone (304) 258-1234

329 Sunrise Blvd
Romney, WV 26757
Phone (304) 822-4932

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1366403461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 310",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-9252",
            "fax_number": "540-722-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 310",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-9252",
            "fax_number": "540-722-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101020542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00208815",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097779000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.